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NPI Code Detail

MEDICARE: MELISSA B HINDS APRN, NNP, PMHNP-BC

MEDICARE: MELISSA B HINDS APRN, NNP, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner209011875IL
2363LN0000XNeonatal Nurse Practitioner209-011875IL

General Provider Information

NPI Number : 1942605142
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA B HINDS APRN, NNP, PMHNP-BC
Provider Business Mailing Address
First Line : 4481 ASH GROVE DR STE B
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62711-6359
Country : US
Telephone Number : 217-803-7341
Fax Number :
Provider Business Practice Location Address
First Line : 4481 ASH GROVE DR STE B
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62711-6359
Country : US
Telephone Number : 217-803-7341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2014
Last Update Date : 09/25/2024

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