Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | CNP.08744 | OH |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | OH-RN131470 | OH |
NPI | 1023127040 |
---|---|
Provider Name | Melissa Kay Zupancic |
First Address | Akron, OH 44313 |
Second Address | Akron, OH 44313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 12/08/2019 |