Provider Demographics
NPI:1952536823
Name:SEXTON, MELISSA DIANE STALLINGS (CPM-TN, RM)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DIANE STALLINGS
Last Name:SEXTON
Suffix:
Gender:F
Credentials:CPM-TN, RM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11555 W 70TH PL
Mailing Address - Street 2:UNIT F
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-1300
Mailing Address - Country:US
Mailing Address - Phone:901-786-3334
Mailing Address - Fax:
Practice Address - Street 1:11555 W 70TH PL
Practice Address - Street 2:UNIT F
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-1300
Practice Address - Country:US
Practice Address - Phone:901-786-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO129175M00000X
TN44175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay