Provider Demographics
NPI:1457199937
Name:CLOUD, MELISSA KAYE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAYE
Last Name:CLOUD
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 1:500 EUNICE BURNS RD
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:OK
Mailing Address - Zip Code:74432-4052
Mailing Address - Country:US
Mailing Address - Phone:580-421-5332
Mailing Address - Fax:
Practice Address - Street 1:500 EUNICE BURNS RD
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:OK
Practice Address - Zip Code:74432-4052
Practice Address - Country:US
Practice Address - Phone:918-618-2168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator