| NPI | 1003101536 | 
|---|---|
| Former Name | MELISSA ANN VONDERHEIDE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024169415)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024169415)  | 
| Enumeration Date | 2011-06-13 | 
| Last Update Date | 2021-07-09 |