Provider Demographics
NPI:1023353174
Name:DVORSCAK, MELISSA M (NP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:DVORSCAK
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 AMERICAN SQ STE 2610
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46282-0004
Mailing Address - Country:US
Mailing Address - Phone:317-559-2055
Mailing Address - Fax:
Practice Address - Street 1:3100 VILLAGE PT
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-9694
Practice Address - Country:US
Practice Address - Phone:219-440-4835
Practice Address - Fax:855-220-2073
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2025-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN28096838A363LF0000X
IN71004259A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily