Healthcare Provider Details

I. General information

NPI: 1316598253
Provider Name (Legal Business Name): MELISSA HILTON CMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 E HILE RD
MUSKEGON MI
49444-4408
US

IV. Provider business mailing address

2367 NORMAN AVE
NORTON SHORES MI
49441-3339
US

V. Phone/Fax

Practice location:
  • Phone: 231-733-4882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number2462173
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: