Individual
MELISSA NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP
Contact information
Practice address
770 E DUPONT RD, FORT WAYNE, IN 46825-2056
(866) 389-2727
Mailing address
770 E DUPONT RD, FORT WAYNE, IN 46825-2056
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209008147
IL
363LF0000X
Family Nurse Practitioner
209008147
IL
363LF0000X
Family Nurse Practitioner
Primary
71006872A
IN
Other
Enumeration date
09/06/2012
Last updated
02/10/2022
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