Provider Demographics
NPI:1609390301
Name:DUVALL, MELISSA E (NP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:E
Last Name:DUVALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1111 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4062
Mailing Address - Country:US
Mailing Address - Phone:330-965-0909
Mailing Address - Fax:330-965-0897
Practice Address - Street 1:1111 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4062
Practice Address - Country:US
Practice Address - Phone:330-965-0909
Practice Address - Fax:330-965-0897
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.021595363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health