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Individual

MELISSA KAYE KOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1 WALTER SCHOLER DR, LAFAYETTE, IN 47909-6303
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28213984A
IN
363LF0000X
Family Nurse Practitioner
Primary
71004908A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000913189
ANTHEM PROVIDER NUMBER
IN
05
201269490
IN
Enumeration date
02/28/2014
Last updated
01/12/2016
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