Provider Demographics
NPI:1063737260
Name:PICKARD, MELANIE JANE (LPN)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:JANE
Last Name:PICKARD
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 1:810 OAKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:OH
Mailing Address - Zip Code:43515-1065
Mailing Address - Country:US
Mailing Address - Phone:419-822-0346
Mailing Address - Fax:
Practice Address - Street 1:810 OAKVIEW DR
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:OH
Practice Address - Zip Code:43515-1065
Practice Address - Country:US
Practice Address - Phone:419-822-0346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH079538164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse