Larson, Melissa

Larson, Melissa is an individual health care provider with primary practice located at 1615 Winsted Dr Ste 1 , Goshen IN 46526-4673. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Larson, Melissa can be contacted via phone (574) 537-1625.

Contact Information

Primary practice address
1615 Winsted Dr Ste 1 Goshen IN 46526-4673
Phone: (574) 537-1625
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71008356A Indiana

Profile Details

NPI number 1336625409
LBN Legal business name Larson, Melissa
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2018
Last updated May 3rd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336625409 NPPES
Indiana MEDICAID 300019082

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