MEDICARE: MELISSA S HORN-HOLLAND RN

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
1	163W00000X	Registered Nurse	28087972	IN

General Provider Information

NPI Number	:	1962448159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA S HORN-HOLLAND RN

Provider Business Mailing Address
First Line	:	10601 N MERIDIAN ST
Second Line	:	# 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1152
Country	:	US
Telephone Number	:	317-575-2700
Fax Number	:	317-575-2713

Provider Business Practice Location Address
First Line	:	10601 N MERIDIAN ST
Second Line	:	# 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1152
Country	:	US
Telephone Number	:	317-575-2700
Fax Number	:	317-575-2713

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	07/08/2007

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