Healthcare Provider Details

I. General information

NPI: 1992277016
Provider Name (Legal Business Name): MELANIE URDAHL KAY NELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2018
Last Update Date: 12/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 MADISON RD
CINCINNATI OH
45227-1491
US

IV. Provider business mailing address

5050 MADISON RD
CINCINNATI OH
45227-1491
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-2800
  • Fax: 513-272-2807
Mailing address:
  • Phone: 513-272-2800
  • Fax: 513-272-2807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1803230
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: