Provider Demographics
NPI:1740896117
Name:STEWART, MELANIE
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:STEWART
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 1:13363 GREENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:WV
Mailing Address - Zip Code:24935-1102
Mailing Address - Country:US
Mailing Address - Phone:304-466-5037
Mailing Address - Fax:
Practice Address - Street 1:13363 GREENVILLE RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:WV
Practice Address - Zip Code:24935-1102
Practice Address - Country:US
Practice Address - Phone:304-466-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant