Provider Demographics
NPI:1376103226
Name:RODRIGUEZ-TERCIUS, MELINDA (FNP-C)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:RODRIGUEZ-TERCIUS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10124 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-9434
Mailing Address - Country:US
Mailing Address - Phone:484-336-8687
Mailing Address - Fax:
Practice Address - Street 1:31 S HIGH ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1132
Practice Address - Country:US
Practice Address - Phone:484-336-8687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024779363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner