Melinda Sue Logan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.026952 Issued in IL

Practice address

1110 Arbor Dr Ste a
Decatur, IL 62526-9289

Phone

(217) 413-8331

NPI assigned

Apr 3, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1265137814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W MACON ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625222753",
            "telephone_number": "217-454-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ARBOR DR STE A",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269289",
            "telephone_number": "217-413-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "MELINDA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.026952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel J. Loban, DDS
• Susan Cassandra Lock, CNM, APN
• Jonathan T Locke, MD
• Loft Rehabilitation of Decatur LLC
• Loft Rehabilitation of Rock Springs LLC
• Suzanne E Logan, PTA
• Long Creek Fire Protection District
• Long Creek Medical LLC
• Danxuan Long, MD
• Elizabeth Long, PHARM.D.

• Family Nurse Practitioner in Decatur, IL
• Providers in Decatur, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.