Provider Demographics
NPI:1992024939
Name:POFF-PIERSON, MELISSA ANN (LPN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:POFF-PIERSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 WALTON CT
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:OH
Mailing Address - Zip Code:45067
Mailing Address - Country:US
Mailing Address - Phone:513-465-5163
Mailing Address - Fax:
Practice Address - Street 1:819 WALTON CT
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:OH
Practice Address - Zip Code:45067
Practice Address - Country:US
Practice Address - Phone:513-465-5163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.135591-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse