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General NPI Number Information
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NPI Number | 1720886534
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Entity Type | Individual
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Provider Name | ELISE DANIELLE MELCHO RN
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Gender | Female
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/09/2025
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Provider Practice Location Address
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Address Line | 3901 S 7TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4299
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Country | US
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Telephone | 812-237-1270
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Fax |
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Provider Business Mailing Address
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Address Line | 312 N GARFIELD ST
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City | OBLONG
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State | IL
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Zip | 62449-1342
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Country | US
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Telephone | 936-500-2822
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Fax |
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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 | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28226056A
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License Number State | IN
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