Provider Demographics
NPI:1396422135
Name:GENSAMER, MELINDA S (RN)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:S
Last Name:GENSAMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:S
Other - Last Name:LOSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1301 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-7439
Mailing Address - Country:US
Mailing Address - Phone:330-206-9191
Mailing Address - Fax:
Practice Address - Street 1:1301 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-7439
Practice Address - Country:US
Practice Address - Phone:330-206-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.410975163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health