Provider Demographics
NPI:1306306055
Name:BODI, MELINDA (RN)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:BODI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:MELESSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3520 HESS RD
Mailing Address - Street 2:
Mailing Address - City:STEWARTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17363-8471
Mailing Address - Country:US
Mailing Address - Phone:717-804-6373
Mailing Address - Fax:
Practice Address - Street 1:2251 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2917
Practice Address - Country:US
Practice Address - Phone:717-804-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY617358163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse