Provider Demographics
NPI:1649238510
Name:MELICK, JOYCE ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:ANN
Last Name:MELICK
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 1:321 RIDGEMERE WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4191
Mailing Address - Country:US
Mailing Address - Phone:740-654-9588
Mailing Address - Fax:740-654-9588
Practice Address - Street 1:321 RIDGEMERE WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4191
Practice Address - Country:US
Practice Address - Phone:740-654-9588
Practice Address - Fax:740-654-9588
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN017670164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2576476Medicaid