Provider Demographics
NPI:1417792672
Name:HALOZAN, MELISSA JANE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:HALOZAN
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 1:7602 SUGARBUSH TRL
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1940
Mailing Address - Country:US
Mailing Address - Phone:513-213-9870
Mailing Address - Fax:
Practice Address - Street 1:7602 SUGARBUSH TRL
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1940
Practice Address - Country:US
Practice Address - Phone:513-213-9870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No172A00000XOther Service ProvidersDriver
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker