Provider Demographics
NPI:1780613679
Name:SEIDOWSKI, MELISSA ANN (CNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:SEIDOWSKI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:NEMETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:2500 METROHEALTH DR
Mailing Address - Street 2:METROHEALTH MEDICAL CENTER - CCH
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:216-778-7800
Mailing Address - Fax:216-252-1118
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:METROHEALTH MEDICAL CENTER - CCH
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-7800
Practice Address - Fax:216-252-1118
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN299859363L00000X
OHCOA.08281-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHQ71002Medicare UPIN
OHNENP79861Medicare ID - Type Unspecified