Provider Demographics
NPI:1629366463
Name:MARCINO, MELISSA CHOLE (CRNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:CHOLE
Last Name:MARCINO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2354
Mailing Address - Country:US
Mailing Address - Phone:740-266-3900
Mailing Address - Fax:740-264-0580
Practice Address - Street 1:3204 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2354
Practice Address - Country:US
Practice Address - Phone:740-266-3900
Practice Address - Fax:740-264-0580
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 12391- NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH036990Medicare PIN