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NPI Code Detail

MEDICARE: MELISSA C FUQUAY NP

MEDICARE: MELISSA C FUQUAY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71000411AIN
2363L00000XNurse Practitioner71000411AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952385791
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA C FUQUAY NP
Provider Business Mailing Address
First Line : PO BOX 3868
Second Line :
City : EVANSVILLE
State : IN
Zip : 47737-3868
Country : US
Telephone Number : 812-426-9545
Fax Number : 812-858-4512
Provider Business Practice Location Address
First Line : 421 CHESTNUT ST
Second Line :
City : EVANSVILLE
State : IN
Zip : 47713-1227
Country : US
Telephone Number : 812-426-9545
Fax Number : 812-858-4512
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 10/31/2024

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Directions to “ MELISSA C FUQUAY NP” Practice Location

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