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Individual

MRS. MELODY HAIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1501 CHESTER BLVD, RICHMOND, IN 47374-1914
(765) 962-1337
(765) 935-7509
Mailing address
1080 UNIVERSITY BLVD, RICHMOND, IN 47374-1256
(765) 914-5847
(765) 373-8579

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000841A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
71000841A
STATE LICENSE
IN
Enumeration date
02/28/2007
Last updated
12/10/2018
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