Individual ProviderMelissa Marie HendersonRegistered NurseNursing Service ProvidersPractice Address77 Academy Ave, Middletown, NY 10940-5226(845) 741-7060PECOS EnrollmentBased on the most recent information from CMS, provider Melissa Marie Henderson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1952636185Provider TypeIndividualFull NameHenderson, Melissa MarieTitleMs.CredentialR.NGenderFemaleSole ProprietorYesEnumeration Date10/6/2009Last Updated10/6/2009Contact InformationPractice LocationPractice Address77 Academy Ave, Middletown, NY 10940-5226Phone(845) 741-7060FaxUnlisted FaxMailing LocationMailing Address77 Academy Ave, Middletown, NY 10940-5226Phone(845) 741-7060FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense542690-1New YorkCode163WP0200XDescriptionRegistered NurseNursing Service ProvidersLicense542690-1New York