Healthcare Provider Details

I. General information

NPI: 1992047609
Provider Name (Legal Business Name): MELISSA CHRISTINE SHERROD RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 NORTHLAND BLVD STE 108
CINCINNATI OH
45246-3609
US

IV. Provider business mailing address

504 COMPTON RD
CINCINNATI OH
45215-4143
US

V. Phone/Fax

Practice location:
  • Phone: 513-828-7418
  • Fax:
Mailing address:
  • Phone: 513-828-7418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN322213
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: