Provider Demographics
NPI:1487540498
Name:DUNHAM, MELISSA L (MSN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:L
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N GREENSBURG ST
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-8095
Mailing Address - Country:US
Mailing Address - Phone:812-292-4099
Mailing Address - Fax:
Practice Address - Street 1:150 E STATE ROAD 250
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47220-2000
Practice Address - Country:US
Practice Address - Phone:812-358-2141
Practice Address - Fax:812-358-1787
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28187156A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner