Provider Demographics
NPI:1861692832
Name:SPLITGERBER, MELANIE SUE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:SUE
Last Name:SPLITGERBER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1800
Mailing Address - Country:US
Mailing Address - Phone:317-873-6438
Mailing Address - Fax:
Practice Address - Street 1:1805 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3130
Practice Address - Country:US
Practice Address - Phone:317-873-6438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002564A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily