Provider Demographics
NPI:1730691825
Name:ADAMS, MELISSA M (LPN)
Entity type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S BREWSTER RD
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8708
Mailing Address - Country:US
Mailing Address - Phone:609-381-2081
Mailing Address - Fax:
Practice Address - Street 1:311 S BREWSTER RD
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8708
Practice Address - Country:US
Practice Address - Phone:609-381-2081
Practice Address - Fax:609-381-2081
Is Sole Proprietor?:No
Enumeration Date:2017-10-29
Last Update Date:2017-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP07443400164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse