Healthcare Provider Details

I. General information

NPI: 1962281212
Provider Name (Legal Business Name): MELISSA DINARDO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 MARKET ST BLDG A1
BOARDMAN OH
44512-3457
US

IV. Provider business mailing address

1327 VIRGINIA AVE
MONACA PA
15061-1954
US

V. Phone/Fax

Practice location:
  • Phone: 330-746-8040
  • Fax:
Mailing address:
  • Phone: 330-604-5845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.0034983
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: