Provider Demographics
NPI:1750870259
Name:PELC, MELISSA (CNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PELC
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 HILL RD N STE A
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9346
Mailing Address - Country:US
Mailing Address - Phone:614-627-1380
Mailing Address - Fax:
Practice Address - Street 1:641 HILL RD N STE A
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9346
Practice Address - Country:US
Practice Address - Phone:614-833-0880
Practice Address - Fax:614-833-6767
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.351031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily