Healthcare Provider Details

I. General information

NPI: 1184154304
Provider Name (Legal Business Name): MELISSA DAWN DAY DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 MAIN ST
MC INTOSH SD
57641-7707
US

IV. Provider business mailing address

208 MAIN ST
MC INTOSH SD
57641-7707
US

V. Phone/Fax

Practice location:
  • Phone: 605-273-4335
  • Fax: 866-423-6811
Mailing address:
  • Phone: 605-273-4335
  • Fax: 866-423-6811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberCP001240
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: