MEDICARE: MELISSA MAE ADAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1376157834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MAE ADAMS

Provider Business Mailing Address
First Line	:	787 WILSON HOLLOW LN
Second Line	:
City	:	WILLIAMSVILLE
State	:	VA
Zip	:	24487-2198
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 LONE OAK DR
Second Line	:
City	:	SENECA ROCKS
State	:	WV
Zip	:	26884-8109
Country	:	US
Telephone Number	:	304-567-2560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2020
Last Update Date	:	09/02/2020

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Directions to “ MELISSA MAE ADAMS ” Practice Location

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