Provider Demographics
NPI:1184130148
Name:TIRADO, MELISSA (CNA)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:TIRADO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CEDAR RUN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2488
Mailing Address - Country:US
Mailing Address - Phone:404-966-4748
Mailing Address - Fax:
Practice Address - Street 1:2 CEDAR RUN APT T
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-2480
Practice Address - Country:US
Practice Address - Phone:718-708-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-28
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0014212290251J00000X, 253Z00000X, 374U00000X, 385HR2065X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health Aide
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child