Provider Demographics
NPI:1730674011
Name:DURHAM, MELANIE ANN (RRT-SDS)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:DURHAM
Suffix:
Gender:F
Credentials:RRT-SDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3275 ROSSVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-1120
Mailing Address - Country:US
Mailing Address - Phone:717-364-2437
Mailing Address - Fax:
Practice Address - Street 1:2233B STOKES RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-1818
Practice Address - Country:US
Practice Address - Phone:717-364-2437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48412279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care