Provider Demographics
NPI:1184928541
Name:SOWERS, MELISSA M (LPN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:SOWERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43217-1035
Mailing Address - Country:US
Mailing Address - Phone:614-260-3033
Mailing Address - Fax:
Practice Address - Street 1:1885 SPRUCE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43217-1035
Practice Address - Country:US
Practice Address - Phone:614-260-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN131391M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse