Provider Demographics
NPI:1558641613
Name:CHESNUT, MELISSA LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LYNN
Last Name:CHESNUT
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 1:4418 CAMDEN WEST ELKTON RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45064-9449
Mailing Address - Country:US
Mailing Address - Phone:513-257-3118
Mailing Address - Fax:
Practice Address - Street 1:4418 CAMDEN WEST ELKTON RD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45064-9449
Practice Address - Country:US
Practice Address - Phone:513-257-3118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.125709 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse