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General NPI Number Information
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NPI Number | 1669067575
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Entity Type | Individual
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Provider Name | MELISSA SMITH
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Gender | Female
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 97 SILVERAGE AVE
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City | MEMPHIS
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State | TN
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Zip | 38109-1823
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Country | US
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Telephone | 901-435-6138
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Fax |
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Provider Business Mailing Address
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Address Line | 97 SILVERAGE AVE
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City | MEMPHIS
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State | TN
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Zip | 38109-1823
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Country | US
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Telephone | 901-378-4004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 4352
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License Number State | TN
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Taxonomy #8
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | TN
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