Healthcare Provider Details

I. General information

NPI: 1699630053
Provider Name (Legal Business Name): MELISSA HARPER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 W PARK ST
URBANA IL
61801-2501
US

IV. Provider business mailing address

1006 BEAVER CREEK LN
MAHOMET IL
61853-9794
US

V. Phone/Fax

Practice location:
  • Phone: 217-383-3311
  • Fax:
Mailing address:
  • Phone: 217-372-8037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041402564
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: