Provider Demographics
NPI:1770863458
Name:KANNLER, MELINDA YVONNE (LPN)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:YVONNE
Last Name:KANNLER
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 1:3922 KING PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-2408
Mailing Address - Country:US
Mailing Address - Phone:513-544-0427
Mailing Address - Fax:
Practice Address - Street 1:8374 BETA AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-6027
Practice Address - Country:US
Practice Address - Phone:513-544-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN114657164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse