Provider Demographics
NPI:1255485488
Name:SCURLOCK, MELANIE SUE (LPN LICENSED PRACTIC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:SUE
Last Name:SCURLOCK
Suffix:
Gender:F
Credentials:LPN LICENSED PRACTIC
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:SUE
Other - Last Name:TOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:841 STEUBENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725
Mailing Address - Country:US
Mailing Address - Phone:855-692-7247
Mailing Address - Fax:
Practice Address - Street 1:841 STEUBENVILLE AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725
Practice Address - Country:US
Practice Address - Phone:855-692-7247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.094531.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2156385OtherOHIO PROVIDER