Healthcare Provider Details

I. General information

NPI: 1447201645
Provider Name (Legal Business Name): MELODY A. ROXBY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2814 W 15TH ST
PANAMA CITY FL
32401-1376
US

IV. Provider business mailing address

161 CANDLEWICK CIR
PANAMA CITY FL
32405-3257
US

V. Phone/Fax

Practice location:
  • Phone: 850-872-4840
  • Fax: 850-872-4468
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN-2249062
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: