Healthcare Provider Details

I. General information

NPI: 1528251113
Provider Name (Legal Business Name): MELISSA CAROL WHITESELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 EATON AVE # 2W
HAMILTON OH
45013-2767
US

IV. Provider business mailing address

630 EATON AVE # 2W
HAMILTON OH
45013-2767
US

V. Phone/Fax

Practice location:
  • Phone: 513-867-2433
  • Fax: 513-867-2499
Mailing address:
  • Phone: 513-867-2433
  • Fax: 513-867-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number285152
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024191033
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4025979
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCOA.09546-NP
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberCOA09546
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: