Provider Demographics
NPI:1730105065
Name:LENKO, MELISSA ANN (DO)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:LENKO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE HEALTHY PLACE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062
Mailing Address - Country:US
Mailing Address - Phone:220-564-1920
Mailing Address - Fax:220-564-1921
Practice Address - Street 1:ONE HEALTHY PLACE
Practice Address - Street 2:SUITE 201
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062
Practice Address - Country:US
Practice Address - Phone:220-564-1920
Practice Address - Fax:220-564-1921
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008531207V00000X
OH34.008531207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2583360Medicaid
OHH465381Medicare PIN
4165521Medicare PIN
136704Medicare UPIN
I36704Medicare UPIN