Provider Demographics
NPI:1326515602
Name:MELECA, VILDAN A (APN)
Entity Type:Individual
Prefix:
First Name:VILDAN
Middle Name:A
Last Name:MELECA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:VILDAN
Other - Middle Name:A
Other - Last Name:MELECA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:1680 EAGLE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9622
Mailing Address - Country:US
Mailing Address - Phone:614-496-2106
Mailing Address - Fax:
Practice Address - Street 1:1680 EAGLE GLEN DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-4300
Practice Address - Country:US
Practice Address - Phone:614-496-2106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH023852363LF0000X
OHAPRN.CNP.023852363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health