Individual
MELISSA BLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4804 TECHNOLOGY DR, MARTINEZ, GA 30907-2605
(706) 339-4142
Mailing address
4804 TECHNOLOGY DR, MARTINEZ, GA 30907-2605
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
R050990
SD
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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