Provider Demographics
NPI:1275970139
Name:LOTTI, MELISSA NICOLE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:NICOLE
Last Name:LOTTI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1626 E STATE ROAD 44
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-4026
Mailing Address - Country:US
Mailing Address - Phone:317-421-2012
Mailing Address - Fax:317-421-2016
Practice Address - Street 1:1728 E STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-1846
Practice Address - Country:US
Practice Address - Phone:317-825-0846
Practice Address - Fax:317-398-1883
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71004437A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily