Provider Demographics
NPI:1154976587
Name:MILLER, MELLISA L (HHA)
Entity type:Individual
Prefix:
First Name:MELLISA
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 THORNWOOD DR LOT 926
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-9574
Mailing Address - Country:US
Mailing Address - Phone:740-641-4675
Mailing Address - Fax:
Practice Address - Street 1:384 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-6849
Practice Address - Country:US
Practice Address - Phone:740-641-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide