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General NPI Number Information
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NPI Number | 1366027096
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Entity Type | Individual
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Provider Name | MELISSA ENID NOEL CNP
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Gender | Female
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 6847 N CHESTNUT ST
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City | RAVENNA
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State | OH
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Zip | 44266-3929
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Country | US
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Telephone | 330-297-2436
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Fax |
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Provider Business Mailing Address
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Address Line | 1798 DREXEL AVE NW
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City | WARREN
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State | OH
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Zip | 44485-2120
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Country | US
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Telephone | 330-639-7709
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN.CNP.0027912
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License Number State | OH
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