Provider Demographics
NPI:1821366691
Name:KREBS, MELISSA ANN (LPN,WCC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:KREBS
Suffix:
Gender:F
Credentials:LPN,WCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WOODLAND HILLS DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SOUTHGATE
Mailing Address - State:KY
Mailing Address - Zip Code:41071-5472
Mailing Address - Country:US
Mailing Address - Phone:513-544-0643
Mailing Address - Fax:
Practice Address - Street 1:16 WOODLAND HILLS DR
Practice Address - Street 2:SUITE 9
Practice Address - City:SOUTHGATE
Practice Address - State:KY
Practice Address - Zip Code:41071-5472
Practice Address - Country:US
Practice Address - Phone:513-544-0643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH134989164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse