Healthcare Provider Details

I. General information

NPI: 1821182460
Provider Name (Legal Business Name): MELIA STOLL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W 15TH ST
LIBERAL KS
67901
US

IV. Provider business mailing address

PO BOX 1340
LIBERAL KS
67905-1340
US

V. Phone/Fax

Practice location:
  • Phone: 620-624-3811
  • Fax: 620-624-3186
Mailing address:
  • Phone: 620-624-3811
  • Fax: 620-624-3186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number44202
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: