Healthcare Provider Details

I. General information

NPI: 1922242270
Provider Name (Legal Business Name): MELINDA SUE HARSHFIELD CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 10/12/2024
Certification Date: 10/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 W MARKET ST STE 2K
LIMA OH
45801-4602
US

IV. Provider business mailing address

730 W MARKET ST STE 2K
LIMA OH
45801-4602
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-5852
  • Fax: 419-996-5854
Mailing address:
  • Phone: 419-996-5852
  • Fax: 419-996-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.10503
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: