Provider Demographics
NPI:1538497425
Name:STRYKUL, MELISSA ELAINE (LPN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ELAINE
Last Name:STRYKUL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-1080
Mailing Address - Country:US
Mailing Address - Phone:419-204-1570
Mailing Address - Fax:
Practice Address - Street 1:256 GROVE ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:OH
Practice Address - Zip Code:45817-1080
Practice Address - Country:US
Practice Address - Phone:419-204-1570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 112178164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse