Provider Demographics
NPI:1972369882
Name:DUKES, MELODY JO
Entity type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:JO
Last Name:DUKES
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 1:124 SHAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-2810
Mailing Address - Country:US
Mailing Address - Phone:903-461-3371
Mailing Address - Fax:
Practice Address - Street 1:124 SHAWNEE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-2810
Practice Address - Country:US
Practice Address - Phone:903-461-3371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant