Provider Demographics
NPI:1619635752
Name:CABANISS, MELANIE A (BBCD, BBCI)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:CABANISS
Suffix:
Gender:F
Credentials:BBCD, BBCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13601 S MIDWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-9356
Mailing Address - Country:US
Mailing Address - Phone:405-308-1575
Mailing Address - Fax:
Practice Address - Street 1:13601 S MIDWEST BLVD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-9356
Practice Address - Country:US
Practice Address - Phone:405-308-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula