Provider Demographics
NPI:1487903977
Name:KING, MELANIE (APRN-C)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:HEIMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:600 PARK ST.
Mailing Address - Street 2:LL045MU
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-4009
Mailing Address - Country:US
Mailing Address - Phone:785-628-4293
Mailing Address - Fax:785-628-4089
Practice Address - Street 1:600 PARK ST
Practice Address - Street 2:STUDENT HEALTH CENTER
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4009
Practice Address - Country:US
Practice Address - Phone:785-628-4293
Practice Address - Fax:785-628-4089
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily