Provider Demographics
NPI:1033519442
Name:HYNES, MELANIE S (NP)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:S
Last Name:HYNES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W MAIN ST STE 330
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-3384
Mailing Address - Country:US
Mailing Address - Phone:937-980-7400
Mailing Address - Fax:937-980-7409
Practice Address - Street 1:700 S STANFIELD RD STE A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373
Practice Address - Country:US
Practice Address - Phone:937-339-5355
Practice Address - Fax:937-339-3056
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.16383363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0122009Medicaid