Provider Demographics
NPI:1366745648
Name:SWOYER, MELYNDA MAE (ARNP)
Entity type:Individual
Prefix:
First Name:MELYNDA
Middle Name:MAE
Last Name:SWOYER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 E WYANDOTTE ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:KS
Mailing Address - Zip Code:66512-9460
Mailing Address - Country:US
Mailing Address - Phone:785-484-2803
Mailing Address - Fax:
Practice Address - Street 1:407 E WYANDOTTE ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:KS
Practice Address - Zip Code:66512-9460
Practice Address - Country:US
Practice Address - Phone:785-484-2803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75178363L00000X
KS75178363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS068002368OtherMEDICARE PTAN
KS200684670AMedicaid
KS068002105OtherMEDICARE PTAN