Provider Demographics
NPI:1326862673
Name:KIRKPATRICK, MELISSA RENEE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:RENEE
Last Name:KIRKPATRICK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12579 OLD MANSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-8727
Mailing Address - Country:US
Mailing Address - Phone:740-504-7944
Mailing Address - Fax:
Practice Address - Street 1:12579 OLD MANSFIELD RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-8727
Practice Address - Country:US
Practice Address - Phone:740-504-7944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant