Healthcare Provider Details

I. General information

NPI: 1003212184
Provider Name (Legal Business Name): MELINDA MCCLENDON RN, AGNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2014
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 BRIARGATE PKWY STE 405
COLORADO SPRINGS CO
80920-7838
US

IV. Provider business mailing address

4110 BRIARGATE PKWY STE 140
COLORADO SPRINGS CO
80920-7836
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-7300
  • Fax: 512-275-2833
Mailing address:
  • Phone: 719-365-7300
  • Fax: 719-365-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberC-APN.0000696-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: