Individual
MELISSA K. GEPHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
7900 W JEFFERSON BLVD STE 304, FORT WAYNE, IN 46804-4128
(260) 458-3600
(260) 458-3601
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003834A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000744783
ANTHEM BCBS
IN
05
—
201044550
—
IN
01
—
71003834A
INDIANA PROFESSIONAL NURSING BOARD LICENSE
IN
Enumeration date
01/03/2012
Last updated
09/23/2020
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