Healthcare Provider Details

I. General information

NPI: 1619558699
Provider Name (Legal Business Name): MELISSA JEAN YANNETTI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 GORDON GUTMANN BLVD STE 201
JEFFERSONVLLE IN
47130-3766
US

IV. Provider business mailing address

301 GORDON GUTMANN BLVD STE 201
JEFFERSONVLLE IN
47130-3766
US

V. Phone/Fax

Practice location:
  • Phone: 812-282-6114
  • Fax:
Mailing address:
  • Phone: 812-282-6114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number5151014823
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number02008483A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: