Provider Demographics
NPI:1518571140
Name:DEAN, MELISSA JANE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:DEAN
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 1:1607 PACKER ST
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-4939
Mailing Address - Country:US
Mailing Address - Phone:412-901-4201
Mailing Address - Fax:
Practice Address - Street 1:1607 PACKER ST
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-4939
Practice Address - Country:US
Practice Address - Phone:412-901-4201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion