MELISSA SUE OTTENWELLER


Address: 3010 Independence Dr, Fort Wayne, IN 46808-1328
Phone: 2607395821

MELISSA SUE OTTENWELLER (NPI# 1881938736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881938736
Entity Type Individual
Full Name MELISSA SUE OTTENWELLER
Other Name MELISSA SUE MEYER
Credential FNP-C
Practice Address 3010 Independence Dr
Fort Wayne
IN 46808-1328
Practice Telephone 2607395821
Practice Fax Number 2605274802
Mailing Telephone 2607395821
Mailing Fax Number 2605274802
Enumeration Date 2012-11-15
Last Update Date 2016-02-01
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 28169657A IN Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
71004278A IN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 3010 INDEPENDENCE DR
City FORT WAYNE
State IN
Zip Code 46808-1328

Providers in the same location

NPI Name Taxonomy Address Enumeration
1336278753 Nikki J Mann Nurse Practitioner 3010 Independence Dr, Fort Wayne, IN 46808-1328 2007-03-02
1104473255 Linzie A Howard Nurse Practitioner 3010 Independence Dr, Fort Wayne, IN 46808-1328 2019-08-23
1780059790 Advanced Care Connections LLC Clinic/Center 3010 Independence Dr, Fort Wayne, IN 46808-1328 2015-12-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295347102 Austin Hartzog Pharmacist 5110 Value Drive, Fort Wayne, IN 46808 2020-08-21
1407358377 Bryan Black Specialist/Technologist 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 2018-03-06
1326557877 Kimberly K Kolb Occupational Therapy Assistant 1431 Runnion Ave, Fort Wayne, IN 46808 2017-09-28
1396142063 Christina Ryder Specialist/Technologist 3946 Iceway, Fort Wayne, IN 46808 2014-11-25
1912090440 Neighborcare of Indiana, LLC Pharmacy 3402 Congressional Pkwy, Ft. Wayne, IN 46808 2006-10-02
1619945888 Beth Ann Herrell Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46808 2006-03-14
1568458990 Carolyn Warner Greer Obstetrics & Gynecology 1415 Directors Row, Fort Wayne, IN 46808 2005-09-21
1750851168 Tyler Cheney Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46808 2018-11-28
1487123550 Michaela Mcguire Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46808 2018-11-19
1861961088 Olivia Marquardt Specialist/Technologist 3946 Ice Way, Fort Wayne, IN 46808 2018-11-16
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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1932725942 Health Essential LLC Nurse Practitioner 3030 Lake Ave Ste 14, Fort Wayne, IN 46805-5428 2020-06-25
1942824842 Carissa Miller Nurse Practitioner 707 Rollingwood Ln, Fort Wayne, IN 46845-1088 2020-06-05
1891329819 Jasmine Monae Tubbs Nurse Practitioner 875 Petal Way, Fort Wayne, IN 46816-8900 2020-02-28
1235780362 Elizabeth Rose Lichtsinn Nurse Practitioner 3919 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-6811 2019-09-20
1033676275 Amanda Warner Nurse Practitioner 2229 Woods Rd, Fort Wayne, IN 46818-9539 2019-02-25
1669940714 Brookelyn Agler Nurse Practitioner Summit Radiology, PC, 5001 Us Highway 30 W, Suite D, Fort Wayne, IN 46818-9701 2018-11-07
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Competitor

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City FORT WAYNE
Zip Code 46808

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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