Basic Information
Provider Information
NPI: 1932515418
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: O'HARRA-BROWN
FirstName: MELISSA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1049 WESTERN AVE
Address2: P.O. BOX 188
City: CHILLICOTHE
State: OH
PostalCode: 456011104
CountryCode: US
TelephoneNumber: 7407734366
FaxNumber:  
Practice Location
Address1: 541 SR 664 N
Address2: SUITE C
City: LOGAN
State: OH
PostalCode: 43138
CountryCode: US
TelephoneNumber: 7403856594
FaxNumber: 7407757855
Other Information
ProviderEnumerationDate: 07/07/2014
LastUpdateDate: 09/07/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XCOA-15998-NPOHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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