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General NPI Number Information
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NPI Number | 1912893793
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Entity Type | Individual
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Provider Name | MELISSA J WENTLAND
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Gender | Female
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 26801 EARLY RD
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City | SOUTH BEND
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State | IN
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Zip | 46628-4549
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Country | US
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Telephone | 574-387-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 N 925 E
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City | MILL CREEK
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State | IN
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Zip | 46365-9741
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Country | US
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Telephone | 574-387-0333
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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