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Individual

R EVELYN MELVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2520 VALLEY DR, PLEASANT VALLEY HOSPITAL, POINT PLEASANT, WV 25550-2031
(304) 674-2403
(304) 675-2240
Mailing address
PO BOX 711841, COLUMBUS, OH 43271-0001
(304) 346-9400
(304) 720-8461

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
25481
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001706470
MSBCBS
WV
01
001721839
MSBCBS
WV
05
0067762000
WV
05
0207026000
WV
05
0767424
OH
01
27005299700
BRICKSTREET
WV
01
270052997003
TRICARE
WV
01
DA0096
RR MEDICARE
WV
01
P00093008
RR MEDICARE
WV
Enumeration date
06/09/2006
Last updated
05/09/2008
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