Provider Demographics
NPI:1730857756
Name:MATHENY, MELANIE (RN)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MATHENY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:PICKENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:19916 ECHO DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-6010
Mailing Address - Country:US
Mailing Address - Phone:330-554-9076
Mailing Address - Fax:
Practice Address - Street 1:12395 MCCRACKEN RD STE H
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2946
Practice Address - Country:US
Practice Address - Phone:216-587-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH346397163WH0200X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health