Provider Demographics
NPI:1700206208
Name:HALL, MELANIE Y (APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:Y
Last Name:HALL
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 RICHMOND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2792
Mailing Address - Country:US
Mailing Address - Phone:216-881-5055
Mailing Address - Fax:
Practice Address - Street 1:464 RICHMOND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2792
Practice Address - Country:US
Practice Address - Phone:216-881-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3004735163WS0200X
OH15904-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool