Provider Demographics
NPI:1932892635
Name:DAVIS, MELINDA LOUISE
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:LOUISE
Last Name:DAVIS
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:PO BOX 257
Mailing Address - Street 2:
Mailing Address - City:NEW VIENNA
Mailing Address - State:OH
Mailing Address - Zip Code:45159-0257
Mailing Address - Country:US
Mailing Address - Phone:937-571-9917
Mailing Address - Fax:
Practice Address - Street 1:101 WEST STREET
Practice Address - Street 2:
Practice Address - City:NEW VIENNA
Practice Address - State:OH
Practice Address - Zip Code:45159-0257
Practice Address - Country:US
Practice Address - Phone:937-571-9917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle