Provider Demographics
NPI:1881629418
Name:GURA, MELANIE L (CNS)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:L
Last Name:GURA
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 ARCH ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1493
Mailing Address - Country:US
Mailing Address - Phone:330-376-7000
Mailing Address - Fax:330-376-1066
Practice Address - Street 1:95 ARCH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1493
Practice Address - Country:US
Practice Address - Phone:330-376-7000
Practice Address - Fax:330-376-1066
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS02727364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2503419Medicaid
OH2503419Medicaid
OHNS04061Medicare PIN