Provider Demographics
NPI:1104249796
Name:HARDING, MELANIE K
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:K
Last Name:HARDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 LA LUZ BLVD APT 217
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-1871
Mailing Address - Country:US
Mailing Address - Phone:315-401-1644
Mailing Address - Fax:
Practice Address - Street 1:489 LA LUZ BLVD APT 217
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1871
Practice Address - Country:US
Practice Address - Phone:315-401-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-02
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.152535164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse