Provider Demographics
NPI:1952607749
Name:SPIKES-ARCHER, MELISSA (NP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:SPIKES-ARCHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1316
Mailing Address - Country:US
Mailing Address - Phone:716-835-4011
Mailing Address - Fax:716-835-0253
Practice Address - Street 1:3350 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1316
Practice Address - Country:US
Practice Address - Phone:716-835-4011
Practice Address - Fax:716-835-0253
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403605363LP0808X
NY518796163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse