Provider Demographics
NPI:1891998191
Name:DAILEY, MELINDA JANE
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:JANE
Last Name:DAILEY
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 1:948 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-5073
Mailing Address - Country:US
Mailing Address - Phone:330-945-6574
Mailing Address - Fax:330-945-6574
Practice Address - Street 1:948 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-5073
Practice Address - Country:US
Practice Address - Phone:330-945-6574
Practice Address - Fax:330-945-6574
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2269192OtherINDEPENDENT PROVIDER #