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General NPI Number Information
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NPI Number | 1588062517
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Entity Type | Individual
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Provider Name | MELISSA NICELEY RN
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Gender | Female
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Dates
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Enumeration Date | 12/08/2014
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 100 DEAN DR
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City | MOUNT ORAB
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State | OH
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Zip | 45154-3505
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Country | US
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Telephone | 937-444-0035
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Fax | 937-444-0036
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Provider Business Mailing Address
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Address Line | 100 DEAN DR
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City | MOUNT ORAB
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State | OH
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Zip | 45154-3505
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Country | US
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Telephone | 937-444-0035
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Fax | 937-444-0036
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.381708
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0039607
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License Number State | OH
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