Provider Demographics
NPI:1124801287
Name:SMITHERS, MELISSA LOUISE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LOUISE
Last Name:SMITHERS
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 1:2709 OAKLAWN BLVD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-4952
Mailing Address - Country:US
Mailing Address - Phone:804-944-5527
Mailing Address - Fax:804-668-5252
Practice Address - Street 1:2709 OAKLAWN BLVD
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-4952
Practice Address - Country:US
Practice Address - Phone:804-944-5527
Practice Address - Fax:804-668-5252
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No171W00000XOther Service ProvidersContractor
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376K00000XNursing Service Related ProvidersNurse's Aide