Provider Demographics
NPI:1780074708
Name:CHRISTIAN, MELINDA DEE (NP)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:DEE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:DEE
Other - Last Name:STIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15500 MIDDLETOWN AVE
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-8488
Mailing Address - Country:US
Mailing Address - Phone:909-238-3863
Mailing Address - Fax:
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:CV ICU
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-944-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28192969A363LP0200X
IN71005372A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN074790066OtherMEDICARE PTAN
IN201392850Medicaid