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General NPI Number Information
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NPI Number | 1366174203
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Entity Type | Individual
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Provider Name | MS. MELISSA S ROUSE
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Gender | Female
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 6220 INWOOD DR
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City | COLUMBUS
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State | IN
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Zip | 47201-2829
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Country | US
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Telephone | 812-373-6488
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Fax | 877-569-2350
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Provider Business Mailing Address
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Address Line | 1130 MEDICAL PL
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City | SEYMOUR
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State | IN
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Zip | 47274-2640
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Country | US
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Telephone | 812-519-1552
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Fax | 812-519-1774
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71012732A
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License Number State | IN
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