Provider Demographics
NPI:1710390554
Name:HONEYCUTT, MELINDA SUE (RN)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:SUE
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2093
Mailing Address - Street 2:
Mailing Address - City:NEW TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37824-2093
Mailing Address - Country:US
Mailing Address - Phone:423-489-3159
Mailing Address - Fax:
Practice Address - Street 1:620 DAVIS DR
Practice Address - Street 2:
Practice Address - City:NEW TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37825-2152
Practice Address - Country:US
Practice Address - Phone:423-489-3159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000176914163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health