MEDICARE: MELISSA UNFRIED FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F01190852	OH

General Provider Information

NPI Number	:	1174097471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA UNFRIED FNP-BC

Provider Business Mailing Address
First Line	:	20050 HARVARD AVE STE 207
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44122-6800
Country	:	US
Telephone Number	:	162-491-1010
Fax Number	:	216-491-4824

Provider Business Practice Location Address
First Line	:	20050 HARVARD AVE STE 207
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44122-6800
Country	:	US
Telephone Number	:	162-491-1010
Fax Number	:	216-491-4824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2019
Last Update Date	:	05/21/2021

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