Provider Demographics
NPI:1912579061
Name:DOTTORE, MELISA (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:
Last Name:DOTTORE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:MELISA
Other - Middle Name:
Other - Last Name:GRABSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:12772 HUNTOON RD
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-8821
Mailing Address - Country:US
Mailing Address - Phone:440-840-8196
Mailing Address - Fax:
Practice Address - Street 1:1615 MORSE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229
Practice Address - Country:US
Practice Address - Phone:716-699-9032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0028442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily