Healthcare Provider Details

I. General information

NPI: 1962287979
Provider Name (Legal Business Name): CHRISTINA MELCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/15/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NORTHCREST DRIVE STE. 520
SPRINGFIELD TN
37172
US

IV. Provider business mailing address

500 NORTHCREST DRIVE DIANA HEALTH, STE. 520
SPRINGFIELD TN
37172
US

V. Phone/Fax

Practice location:
  • Phone: 615-219-6190
  • Fax: 615-301-1807
Mailing address:
  • Phone: 615-219-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number257384
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number34224
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number34224
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: