Melinda Sue Dial, FNP
Nurse Practitioner, Family in Bloomington, IL. Individual provider (NPI-1).
NPI number1235765249
StatusActive
Last updated in NPPESJan 20, 2022
Details
- NPI
- 1235765249
- Entity type
- Individual (NPI-1)
- Name
- Melinda Sue Dial
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2020
- Certification date
- Jan 20, 2022
- Last updated
- Jan 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 209020879 | IL | Yes |
Practice location
702 W Chestnut StBloomington, IL 61701-2814
Phone 618-877-4420
Mailing address
419 S Walnut StWapella, IL 61777-2501
Phone 217-871-8050
Other practice locations
419 S Walnut St
Wapella, IL 61777-2501
Wapella, IL 61777-2501
Phone 217-871-8050
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