=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710262498
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELANIE JOAN ANTONICH ARNP, CNM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2011
-----------------------------------------------------
Last Update Date | 11/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 945 GOETHALS DR STE 200
-----------------------------------------------------
City | RICHLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99352-3552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-942-2555
-----------------------------------------------------
Fax | 509-942-2340
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 945 GOETHALS DR STE 200
-----------------------------------------------------
City | RICHLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99352-3552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-942-2555
-----------------------------------------------------
Fax | 509-942-2340
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number | AP60262504
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP60188632
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 256983
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------