Provider Demographics
NPI:1720674567
Name:SHROYER, MELISSA DEANN
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:DEANN
Last Name:SHROYER
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 1:1021 JUNIPER WAY
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-1021
Mailing Address - Country:US
Mailing Address - Phone:937-538-6124
Mailing Address - Fax:
Practice Address - Street 1:1021 JUNIPER WAY
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-1021
Practice Address - Country:US
Practice Address - Phone:937-538-6124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide