Provider Demographics
NPI:1134593627
Name:MELNICK, CINDY (CRNP)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:MELNICK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:CLOUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:307 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1621
Mailing Address - Country:US
Mailing Address - Phone:717-231-8540
Mailing Address - Fax:717-231-8588
Practice Address - Street 1:4400 CARLISLE PIKE
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4132
Practice Address - Country:US
Practice Address - Phone:717-975-9800
Practice Address - Fax:717-975-5509
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103066896Medicaid