Provider Demographics
NPI:1194142752
Name:MAY, MELISSA (STNA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 ARLINGTON AVE SW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44706-1137
Mailing Address - Country:US
Mailing Address - Phone:330-361-0202
Mailing Address - Fax:
Practice Address - Street 1:214 ARLINGTON AVE SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44706-1137
Practice Address - Country:US
Practice Address - Phone:330-361-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401607870114376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide