Provider Demographics
NPI:1871107599
Name:CALIXTO, MELANIE ANNA
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANNA
Last Name:CALIXTO
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 1:33 SKYWARD LN
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:WV
Mailing Address - Zip Code:26801-8347
Mailing Address - Country:US
Mailing Address - Phone:540-244-4376
Mailing Address - Fax:
Practice Address - Street 1:33 SKYWARD LN
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:WV
Practice Address - Zip Code:26801-8347
Practice Address - Country:US
Practice Address - Phone:540-244-4376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant