Healthcare Provider Details

I. General information

NPI: 1295662666
Provider Name (Legal Business Name): MELISSA LYNDSEY MORELAND LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 16TH AVE NW
ROCHESTER MN
55901-7763
US

IV. Provider business mailing address

2924 16TH AVE NW
ROCHESTER MN
55901-7763
US

V. Phone/Fax

Practice location:
  • Phone: 202-368-1719
  • Fax:
Mailing address:
  • Phone: 202-368-1719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1117
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: