Basic Information
| Provider Information | |||||||||
| NPI: | 1750870259 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PELC | ||||||||
| FirstName: | MELISSA | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 641 HILL RD N STE A | ||||||||
| Address2: | |||||||||
| City: | PICKERINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431479346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6146271380 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 641 HILL RD N STE A | ||||||||
| Address2: | |||||||||
| City: | PICKERINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431479346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148330880 | ||||||||
| FaxNumber: | 6148336767 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2018 | ||||||||
| LastUpdateDate: | 09/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN.351031 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.