Most Relevant Information
Provider Data
| NPI Number: | 1003563834 |
| Provider Name: | MELANIE SAMPLE RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WG0600X |
| Specialty: | Registered Nurse |
| License Number: | 28151524A |
Most Important Dates
| Enumeration Date: | 03/02/2022 |
| Last Updated: | 03/02/2022 |
Provider Practice Location
9268 E TATE RIDGE RD
MADISON
IN
472508756
Practice Location Phone/Fax
| Phone: | 8124933993 |
| Fax: |
Provider Mailing Location
9268 E TATE RIDGE RD
MADISON
IN
472508756
Provider Mailing Phone/Fax
| Phone: | 8124933993 |
| Fax: |