Mellick, Kimberly Ann
Mellick, Kimberly Ann is an individual health care provider with primary practice located at 1415 S Hwy 89 , Jackson WY 83001-8515. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mellick, Kimberly Ann can be contacted via phone (307) 739-8999.Contact Information
Primary practice address
1415 S Hwy 89
Jackson WY 83001-8515
Phone: (307) 739-8999
Fax: (307) 739-9222
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 1137 | Wyoming |
Profile Details
| NPI number | 1073897930 |
|---|---|
| LBN Legal business name | Mellick, Kimberly Ann |
| Credentials | MSN, FNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2011 |
| Last updated | Feb 15th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073897930 | NPPES |
| Wyoming | MEDICAID | 121882400 |
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