Healthcare Provider Details

I. General information

NPI: 1659869717
Provider Name (Legal Business Name): MELISSA ANN BRYSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 SMITH RD STE 300
CINCINNATI OH
45209-1974
US

IV. Provider business mailing address

2139 AUBURN AVE
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-751-2273
  • Fax: 513-751-1848
Mailing address:
  • Phone: 513-585-0690
  • Fax: 513-585-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number021588
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.021588
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: