Healthcare Provider Details

I. General information

NPI: 1205399771
Provider Name (Legal Business Name): MELISSA ANNE HENRY SWEET CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 W LONG ST
COLUMBUS OH
43215-2815
US

IV. Provider business mailing address

16 W LONG ST
COLUMBUS OH
43215-2815
US

V. Phone/Fax

Practice location:
  • Phone: 614-225-0990
  • Fax:
Mailing address:
  • Phone: 614-225-0990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number392247
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number024743
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: