| Doctor Name: | TERESA E. MELLINGTON |
| NPI Number: | 1003062670 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ACNP-BC, AOCNP |
| License Number: | COA10168NP |
| Business Practice Address: | 8401 Market St Boardman, OH - 445126725 |
| Business Phone Number: | 3306297500 |
| Business Fax Number: | 3306297504 |
| Mailing Address: | Po Box 636988, CINCINNATI |
| State: | OH |
| Postal Code: | 452636988 |
| Phone Number: | 8889402722 |
| Fax Number: | 5136328898 |
| NPI Enumeration Date: | 08/14/2008 |
| NPI Last Update Date: | 10/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | COA10168NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |