Provider Demographics
NPI:1194798603
Name:VANCE, MELISSA ANNE (FNP-BC, DCNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANNE
Last Name:VANCE
Suffix:
Gender:F
Credentials:FNP-BC, DCNP
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:TELENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC, DCNP
Mailing Address - Street 1:2000 AUBURN DR
Mailing Address - Street 2:STE 350
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4327
Mailing Address - Country:US
Mailing Address - Phone:216-417-3250
Mailing Address - Fax:216-417-3251
Practice Address - Street 1:2141 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-3435
Practice Address - Country:US
Practice Address - Phone:440-443-0442
Practice Address - Fax:440-755-8010
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.289913363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2873912Medicaid
OHQ30848Medicare UPIN