Healthcare Provider Details

I. General information

NPI: 1194644021
Provider Name (Legal Business Name): MELISSA HELEN RIEGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 CLINIC DR
WEST LAFAYETTE IN
47907-2122
US

IV. Provider business mailing address

4401 W LEGACY DR
MUNCIE IN
47304-5981
US

V. Phone/Fax

Practice location:
  • Phone: 765-494-8591
  • Fax:
Mailing address:
  • Phone: 765-702-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: