Provider Demographics
NPI:1710693981
Name:GIRVEN, MELISSA CAROLINE (RN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:CAROLINE
Last Name:GIRVEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11071 HIGHWAY FF
Mailing Address - Street 2:
Mailing Address - City:MAYVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64071-2524
Mailing Address - Country:US
Mailing Address - Phone:417-684-6900
Mailing Address - Fax:
Practice Address - Street 1:11071 HIGHWAY FF
Practice Address - Street 2:
Practice Address - City:MAYVIEW
Practice Address - State:MO
Practice Address - Zip Code:64071-2524
Practice Address - Country:US
Practice Address - Phone:417-684-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013023576163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse