Provider Demographics
NPI:1417696816
Name:HALL, MELISSA RENEE (APRN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:RENEE
Last Name:HALL
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:3963 TALBOT DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5948
Mailing Address - Country:US
Mailing Address - Phone:314-546-6006
Mailing Address - Fax:
Practice Address - Street 1:3778 MEDINA RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256
Practice Address - Country:US
Practice Address - Phone:330-764-3457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2020033728208D00000X
OH0034113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice