Provider Demographics
NPI:1700120557
Name:SWINDELL, MELISSA GRACE (LPN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:GRACE
Last Name:SWINDELL
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 1:2380 STATE ROUTE 681 N
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:45710-9455
Mailing Address - Country:US
Mailing Address - Phone:740-591-7702
Mailing Address - Fax:
Practice Address - Street 1:2380 STATE ROUTE 681 N
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OH
Practice Address - Zip Code:45710-9455
Practice Address - Country:US
Practice Address - Phone:740-591-7702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-17
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH136803164W00000X
OHPN136803164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse