Healthcare Provider Details

I. General information

NPI: 1922731520
Provider Name (Legal Business Name): MELISSA SUSAN BLIX CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA SCHERBER

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 N MERIDIAN ST
CARMEL IN
46032-4656
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-577-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2760
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number28299574A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number2145138
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: