Provider Demographics
NPI:1942807557
Name:WOODYARD, MELISSA ELLEN
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ELLEN
Last Name:WOODYARD
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 1:125 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PETERSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:24963-6698
Mailing Address - Country:US
Mailing Address - Phone:540-629-0223
Mailing Address - Fax:
Practice Address - Street 1:125 CHURCH ST
Practice Address - Street 2:
Practice Address - City:PETERSTOWN
Practice Address - State:WV
Practice Address - Zip Code:24963-6698
Practice Address - Country:US
Practice Address - Phone:540-629-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant