Provider Demographics
NPI:1780226662
Name:SCHRUM, MELISSA ANN (CNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:SCHRUM
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:EBERHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1112 S LAKE AVE STE 201
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1300
Practice Address - Country:US
Practice Address - Phone:605-312-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-12
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP001657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily