MEDICARE: MR. MELVIN KILE VINEY JR. APRN-BC

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	363LF0000X	Family Nurse Practitioner	53-76305-032	KS
2	363LF0000X	Family Nurse Practitioner	0993946	CO

General Provider Information

NPI Number	:	1629207931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MELVIN KILE VINEY JR. APRN-BC

Provider Business Mailing Address
First Line	:	420 VASA WAY
Second Line	:
City	:	LINDSBORG
State	:	KS
Zip	:	67456-6051
Country	:	US
Telephone Number	:	719-529-2220
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 W 12TH AVE
Second Line	:
City	:	EMPORIA
State	:	KS
Zip	:	66801-2504
Country	:	US
Telephone Number	:	620-343-6800
Fax Number	:	620-341-7821

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

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	05/08/2026

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