Provider Demographics
NPI:1578304804
Name:MYLES, MELISSA C
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:C
Last Name:MYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CURTS
Other - Middle Name:J
Other - Last Name:MYLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2500 ROSEBUSH RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-5507
Mailing Address - Country:US
Mailing Address - Phone:334-718-8459
Mailing Address - Fax:
Practice Address - Street 1:2500 ROSEBUSH RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-5507
Practice Address - Country:US
Practice Address - Phone:334-718-8459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider