Provider Demographics
NPI:1588170567
Name:BARTLETT, MELISSA JOAN
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOAN
Last Name:BARTLETT
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 1:428 STORY ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-3532
Mailing Address - Country:US
Mailing Address - Phone:515-432-3277
Mailing Address - Fax:515-432-3277
Practice Address - Street 1:428 STORY ST
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036
Practice Address - Country:US
Practice Address - Phone:515-432-3277
Practice Address - Fax:515-432-3277
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074715231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA074715OtherHEARING AIDS, ASSISTIVE DEVICES