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NPI Code Detail

MEDICARE: MS. MELANIE J DUNLAP CFNP

MEDICARE: MS. MELANIE J DUNLAP CFNP
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
1363LF0000XFamily Nurse PractitionerR081181-7MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R0811817OTHERMNMN LIC NUMBER

General Provider Information

NPI Number : 1710906581
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELANIE J DUNLAP CFNP
Provider Business Mailing Address
First Line : 4670 PARK NICOLLET AVE SE
Second Line :
City : PRIOR LAKE
State : MN
Zip : 55372-4119
Country : US
Telephone Number : 952-993-7750
Fax Number : 952-993-8820
Provider Business Practice Location Address
First Line : 4670 PARK NICOLLET AVE SE
Second Line :
City : PRIOR LAKE
State : MN
Zip : 55372-4119
Country : US
Telephone Number : 952-993-7750
Fax Number : 952-993-8820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 04/01/2008

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