Healthcare Provider Details

I. General information

NPI: 1194798603
Provider Name (Legal Business Name): MELISSA ANNE VANCE FNP-BC, DCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA TELENKO FNP-BC, DCNP

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 LAKE AVE
ASHTABULA OH
44004-3435
US

IV. Provider business mailing address

2000 AUBURN DR STE 350
BEACHWOOD OH
44122-4327
US

V. Phone/Fax

Practice location:
  • Phone: 440-443-0442
  • Fax: 440-755-8010
Mailing address:
  • Phone: 216-417-3250
  • Fax: 216-417-3251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN.289913
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: