Provider Demographics
NPI:1871860734
Name:WORDEN, MELISSA LYNN
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:LYNN
Last Name:WORDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 OAKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-8824
Mailing Address - Country:US
Mailing Address - Phone:414-581-9366
Mailing Address - Fax:
Practice Address - Street 1:2920 OAKWOOD RD
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8824
Practice Address - Country:US
Practice Address - Phone:414-581-9366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula