Provider Demographics
NPI:1235901059
Name:DELONG, MELISSA NICHOLE (CNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:NICHOLE
Last Name:DELONG
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:NICHOLE
Other - Last Name:SCHNIPKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15655 ROAD 23M
Mailing Address - Street 2:
Mailing Address - City:FORT JENNINGS
Mailing Address - State:OH
Mailing Address - Zip Code:45844-9021
Mailing Address - Country:US
Mailing Address - Phone:567-712-0855
Mailing Address - Fax:
Practice Address - Street 1:15655 ROAD 23M
Practice Address - Street 2:
Practice Address - City:FORT JENNINGS
Practice Address - State:OH
Practice Address - Zip Code:45844-9021
Practice Address - Country:US
Practice Address - Phone:567-712-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032835363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily