Provider Demographics
NPI:1770324089
Name:CICCARELLI, MELINDA RUTH
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:RUTH
Last Name:CICCARELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 BERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MUNROE FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44262-1106
Mailing Address - Country:US
Mailing Address - Phone:330-472-9381
Mailing Address - Fax:
Practice Address - Street 1:240 BERMONT AVE
Practice Address - Street 2:
Practice Address - City:MUNROE FALLS
Practice Address - State:OH
Practice Address - Zip Code:44262-1106
Practice Address - Country:US
Practice Address - Phone:330-472-9381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker