Provider Demographics
NPI:1932825429
Name:MELTON, SHELISSKIA
Entity Type:Individual
Prefix:
First Name:SHELISSKIA
Middle Name:
Last Name:MELTON
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 1:2936 W TURNER RD
Mailing Address - Street 2:
Mailing Address - City:WHISTLER
Mailing Address - State:AL
Mailing Address - Zip Code:36612-2053
Mailing Address - Country:US
Mailing Address - Phone:251-533-1717
Mailing Address - Fax:
Practice Address - Street 1:2936 W TURNER RD
Practice Address - Street 2:
Practice Address - City:WHISTLER
Practice Address - State:AL
Practice Address - Zip Code:36612-2053
Practice Address - Country:US
Practice Address - Phone:251-533-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health