Provider Demographics
NPI:1801112776
Name:KITCHENS, MELANIE LOUISE (CLD, CCCE)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:LOUISE
Last Name:KITCHENS
Suffix:
Gender:F
Credentials:CLD, CCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3153 N AMMONS DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-5382
Mailing Address - Country:US
Mailing Address - Phone:360-560-5495
Mailing Address - Fax:
Practice Address - Street 1:3153 N AMMONS DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-5382
Practice Address - Country:US
Practice Address - Phone:360-560-5495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula