Individual
MELISSA DEMETRIOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
100 NAVARRE PL, STE 4440, SOUTH BEND, IN 46601-1171
(574) 647-5300
(574) 647-5305
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-3245
(574) 647-1840
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007429A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300022470
—
IN
Enumeration date
07/19/2017
Last updated
04/04/2024
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