Provider Demographics
NPI:1639335185
Name:VARRA, MELISSA ANN (SA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:VARRA
Suffix:
Gender:F
Credentials:SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1358
Mailing Address - Country:US
Mailing Address - Phone:303-217-3937
Mailing Address - Fax:
Practice Address - Street 1:2014 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1358
Practice Address - Country:US
Practice Address - Phone:303-217-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No172V00000XOther Service ProvidersCommunity Health Worker