Provider Demographics
NPI:1184230203
Name:HALTERMAN, MELINDA (PMHNP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:HALTERMAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8844 IDAHO DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-9028
Mailing Address - Country:US
Mailing Address - Phone:812-453-5504
Mailing Address - Fax:
Practice Address - Street 1:101 PLAZA EAST BLVD STE 303
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2871
Practice Address - Country:US
Practice Address - Phone:812-491-1307
Practice Address - Fax:812-473-1035
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71010396A363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner