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NPI Code Detail

MEDICARE: MELISSA J WIESENHAHN CNP

MEDICARE: MELISSA J WIESENHAHN CNP
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
1363LF0000XFamily Nurse PractitionerCOA.18659-NPOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396199428
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA J WIESENHAHN CNP
Provider Business Mailing Address
First Line : 5885 HARRISON AVE STE 2500
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-1726
Country : US
Telephone Number : 513-347-2300
Fax Number : 513-451-2135
Provider Business Practice Location Address
First Line : 5885 HARRISON AVE STE 2500
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-1726
Country : US
Telephone Number : 513-347-2300
Fax Number : 513-451-2135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2016
Last Update Date : 02/19/2020

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