Provider Demographics
NPI:1982474227
Name:FELT, MELINDA JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:JEAN
Last Name:FELT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:JEAN
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2521 ELMS STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433
Mailing Address - Country:US
Mailing Address - Phone:104-875-5571
Mailing Address - Fax:
Practice Address - Street 1:2521 ELMS STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433
Practice Address - Country:US
Practice Address - Phone:810-487-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704394990163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation