Provider Demographics
NPI:1316658818
Name:BURDA-RODGERS, MELODY A (RN CCM)
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:A
Last Name:BURDA-RODGERS
Suffix:
Gender:F
Credentials:RN CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11004 OLIVERDA DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-4443
Mailing Address - Country:US
Mailing Address - Phone:502-599-8836
Mailing Address - Fax:
Practice Address - Street 1:3001 W BIG BEAVER RD STE 210
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3103
Practice Address - Country:US
Practice Address - Phone:800-477-2057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1078669163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management