Provider Demographics
NPI:1942033881
Name:POE, MELINDA (FNP-C)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:POE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 OVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-0997
Mailing Address - Country:US
Mailing Address - Phone:903-413-1180
Mailing Address - Fax:
Practice Address - Street 1:755 W BIG BEAVER RD STE 400
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4902
Practice Address - Country:US
Practice Address - Phone:877-340-1697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily