Provider Demographics
NPI:1629260708
Name:NEHLS, MELANIE S (LPN)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:S
Last Name:NEHLS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-5083
Mailing Address - Country:US
Mailing Address - Phone:304-261-1241
Mailing Address - Fax:
Practice Address - Street 1:158 SYCAMORE RD
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425-5083
Practice Address - Country:US
Practice Address - Phone:304-261-1241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP40932164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse