Provider Demographics
NPI:1619453974
Name:MILOS, MELINDA KAY
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:KAY
Last Name:MILOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:KAY
Other - Last Name:HERSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:832 RICHMAR DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1338
Mailing Address - Country:US
Mailing Address - Phone:330-464-5013
Mailing Address - Fax:
Practice Address - Street 1:35500 CHESTER RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011
Practice Address - Country:US
Practice Address - Phone:440-754-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily