Provider Demographics
NPI:1770892069
Name:DODD WESLEY, MELANIE (RN)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:DODD WESLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 DONAGHEY AVE APT 4505
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-2365
Mailing Address - Country:US
Mailing Address - Phone:870-995-3320
Mailing Address - Fax:501-500-5772
Practice Address - Street 1:1100 OAK ST # L2
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4318
Practice Address - Country:US
Practice Address - Phone:870-995-3320
Practice Address - Fax:501-500-5772
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR91910163WC2100X
ARR091910163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care