Healthcare Provider Details

I. General information

NPI: 1922287705
Provider Name (Legal Business Name): MELISSA MARIE DINSMORE RN, CCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
MIDDLETOWN OH
45005-2584
US

IV. Provider business mailing address

1 MEDICAL CENTER DR SUITE 227
MIDDLETOWN OH
45005-2584
US

V. Phone/Fax

Practice location:
  • Phone: 513-705-5194
  • Fax:
Mailing address:
  • Phone: 937-667-5994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberCOA.09355-NS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: