Provider Demographics
NPI:1720885312
Name:MELVIN, JENNIFER NAOMI
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NAOMI
Last Name:MELVIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:JUNIATA
Mailing Address - State:NE
Mailing Address - Zip Code:68955-5520
Mailing Address - Country:US
Mailing Address - Phone:308-539-3367
Mailing Address - Fax:
Practice Address - Street 1:303 W 5TH ST
Practice Address - Street 2:
Practice Address - City:JUNIATA
Practice Address - State:NE
Practice Address - Zip Code:68955-5520
Practice Address - Country:US
Practice Address - Phone:308-539-3367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider