Provider Demographics
NPI:1982256368
Name:HOSTETTER, MELISSA ROSE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ROSE
Last Name:HOSTETTER
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 1:452 CENTRAL MANOR RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-1606
Mailing Address - Country:US
Mailing Address - Phone:717-380-2743
Mailing Address - Fax:717-798-9836
Practice Address - Street 1:452 CENTRAL MANOR RD
Practice Address - Street 2:
Practice Address - City:MOUNTVILLE
Practice Address - State:PA
Practice Address - Zip Code:17554-1606
Practice Address - Country:US
Practice Address - Phone:717-380-2743
Practice Address - Fax:717-798-9836
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife