Provider Demographics
NPI:1194098830
Name:NEAL, MELANIE NOEL (CRNA)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:NOEL
Last Name:NEAL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:NOEL
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4225
Mailing Address - Fax:513-636-2511
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4225
Practice Address - Fax:513-636-2511
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN277534367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201056240Medicaid
OH000000752670OtherANTHEM
OH000000752670OtherANTHEM
IN201056240Medicaid