Healthcare Provider Details

I. General information

NPI: 1811851215
Provider Name (Legal Business Name): MELISSA BENNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 OLD CAMPBELLTOWN RD
MARLINTON WV
24954-6526
US

IV. Provider business mailing address

571 OLD CAMPBELLTOWN RD
MARLINTON WV
24954-6526
US

V. Phone/Fax

Practice location:
  • Phone: 304-799-7274
  • Fax:
Mailing address:
  • Phone: 304-799-7274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: