MEDICARE: MELODY KAY NOE P. A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	2509	CO

General Provider Information

NPI Number	:	1619140654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELODY KAY NOE P. A.

Provider Business Mailing Address
First Line	:	8057 S TRENTON CT
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-3207
Country	:	US
Telephone Number	:	303-548-4350
Fax Number	:	303-344-0200

Provider Business Practice Location Address
First Line	:	4101 W CONEJOS PL
Second Line	:	SUITE 225
City	:	DENVER
State	:	CO
Zip	:	80204-1377
Country	:	US
Telephone Number	:	303-595-6765
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2008
Last Update Date	:	04/20/2020

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