Provider Demographics
NPI:1992047609
Name:SHERROD, MELISSA CHRISTINE (RN BSN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:CHRISTINE
Last Name:SHERROD
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 COMPTON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-4143
Mailing Address - Country:US
Mailing Address - Phone:513-828-7418
Mailing Address - Fax:
Practice Address - Street 1:230 NORTHLAND BLVD STE 108
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3609
Practice Address - Country:US
Practice Address - Phone:513-828-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN322213163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine