Provider Demographics
NPI:1902497746
Name:DAINS, MELISSA ANN (LPN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:DAINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2395 STALEY RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-2044
Mailing Address - Country:US
Mailing Address - Phone:716-982-1080
Mailing Address - Fax:
Practice Address - Street 1:2395 STALEY RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-2044
Practice Address - Country:US
Practice Address - Phone:716-982-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32085901164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty