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General NPI Number Information
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NPI Number | 1790228070
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Entity Type | Individual
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Provider Name | MELISSA CAIN NP
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Gender | Female
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 01/12/2017
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Provider Practice Location Address
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Address Line | 3405 W PITTSBURG ST
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City | BROKEN ARROW
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State | OK
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Zip | 74012-6112
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Country | US
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Telephone | 918-760-7980
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Fax |
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Provider Business Mailing Address
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Address Line | 3405 W PITTSBURG ST
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City | BROKEN ARROW
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State | OK
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Zip | 74012-6112
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Country | US
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Telephone | 918-760-7980
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R0078791
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 78791
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License Number State | OK
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