Healthcare Provider Details

I. General information

NPI: 1740699354
Provider Name (Legal Business Name): MELISSA TAYLOR CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N MAIN ST
AKRON OH
44310-3110
US

IV. Provider business mailing address

444 N MAIN ST
AKRON OH
44310-3110
US

V. Phone/Fax

Practice location:
  • Phone: 330-668-4040
  • Fax:
Mailing address:
  • Phone: 330-668-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.16175
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNP-16175
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: