Healthcare Provider Details

I. General information

NPI: 1245883511
Provider Name (Legal Business Name): MELISSA LOWE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA WISEMAN

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ARCH ST STE 95
AKRON OH
44304-1437
US

IV. Provider business mailing address

95 ARCH ST STE 165
AKRON OH
44304-1488
US

V. Phone/Fax

Practice location:
  • Phone: 330-374-1255
  • Fax: 724-658-5767
Mailing address:
  • Phone: 303-741-2553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.025076
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN.CNP.025076
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: