Healthcare Provider Details

I. General information

NPI: 1336471119
Provider Name (Legal Business Name): MELINDA J. ENGEL RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 LAKELAND DR STE 750 MISSISSIPPI ONCOLOGY ASSOCIATES
JACKSON MS
39216
US

IV. Provider business mailing address

971 LAKELAND DR STE 750 MISSISSIPPI ONCOLOGY ASSOCIATES
JACKSON MS
39216
US

V. Phone/Fax

Practice location:
  • Phone: 601-947-9995
  • Fax: 601-987-9830
Mailing address:
  • Phone: 601-987-3033
  • Fax: 601-987-8768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberR857914
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: