Provider Demographics
NPI:1447540695
Name:SKIPPER, MELINDA ALANNA (APRN)
Entity type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:ALANNA
Last Name:SKIPPER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3488 SELDOM SEEN RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8405
Mailing Address - Country:US
Mailing Address - Phone:614-718-1508
Mailing Address - Fax:
Practice Address - Street 1:3488 SELDOM SEEN RD
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8405
Practice Address - Country:US
Practice Address - Phone:614-718-1508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.285897163W00000X
OHAPRN.CNP.12179363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3142629Medicaid