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Individual

MELISSA SUE SKINNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
603 S 900 W-92, PIERCETON, IN 46562-9634
(260) 437-4847

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28153854A
IN
363LF0000X
Family Nurse Practitioner
Primary
71009571A
IN
363LF0000X
Family Nurse Practitioner
71009571B
IN

Other

Enumeration date
11/18/2019
Last updated
10/12/2023
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