Melissa Joy Bourne, RN
Individual provider Active NPI Home Health Registered Nurse · Princeton, WV
NPI 1013794643 · NPPES record last updated Sep 8, 2023
Key facts
- NPI
- 1013794643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Registered Nurse 163WH0200X
- License
- 45768 (WV)
- Practice address
- 1908 Glenwood Park Rd
Princeton, WV 24739-7969 - Phone
- (304) 325-6202
- Fax
- (304) 323-2307
- NPI assigned
- Sep 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45768 | WV | MD | Home Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stonerise Reliable Healthcare LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 45768 | WV | Yes |
Addresses
Primary practice location
1908 Glenwood Park Rd
Princeton, WV 24739-7969
Mailing address
1908 Glenwood Park Rd
Princeton, WV 24739-7969
Phone (304) 325-6202
Other providers in Princeton, WV
- Josiah Bolyard
- Jordyn Boone
- Tina Renee Borich
- Justice Boswell
- Tasha Boswell
- Donald Eugene Bowen Jr.
- Erika Dawn Bowling
- Gena Bowling
- James Bowling
- Jenna Bowling
All providers in Princeton, WV · Home Health Registered Nurse in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.