Healthcare Provider Details

I. General information

NPI: 1760988000
Provider Name (Legal Business Name): MELANIE DAWN EMILY DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELANIE DAWN ROMEREIM

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 95
BELPRE KS
67519-0095
US

IV. Provider business mailing address

1905 19TH ST
GREAT BEND KS
67530-2502
US

V. Phone/Fax

Practice location:
  • Phone: 620-910-7028
  • Fax: 620-710-7725
Mailing address:
  • Phone: 620-792-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number78133
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number78133
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: