Provider Demographics
NPI:1821724766
Name:EVANS, MELANIE DANIELLE (PNHNP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:DANIELLE
Last Name:EVANS
Suffix:
Gender:F
Credentials:PNHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 VERULAM AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-2418
Mailing Address - Country:US
Mailing Address - Phone:513-841-3041
Mailing Address - Fax:
Practice Address - Street 1:5500 VERULAM AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-2418
Practice Address - Country:US
Practice Address - Phone:513-841-3014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCPN0031896163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health