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General NPI Number Information
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NPI Number | 1538206545
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Entity Type | Individual
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Provider Name | MELANIE MARIE PERKINS-FAIRBANKS NP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 111 S BROAD ST STE 209
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City | LANCASTER
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State | OH
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Zip | 43130
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Country | US
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Telephone | 614-301-6479
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Fax | 740-277-7433
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Provider Business Mailing Address
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Address Line | 111 S BROAD ST STE 209
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City | LANCASTER
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State | OH
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Zip | 43130-4383
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Country | US
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Telephone | 614-301-6479
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Fax | 740-277-7433
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.07832
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP07832
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License Number State | OH
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