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General NPI Number Information
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NPI Number | 1790612851
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Entity Type | Individual
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Provider Name | MELISSA ANN BAHAM RN
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Gender | Female
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 810 MEDICAL PARK
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City | SMYRNA
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State | TN
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Zip | 37167-2843
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Country | US
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Telephone | 615-223-5565
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Fax | 615-223-5509
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Provider Business Mailing Address
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Address Line | 10352 VALLEY VIEW RD
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City | LASCASSAS
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State | TN
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Zip | 37085-4124
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Country | US
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Telephone |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 288961
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License Number State | TN
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