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General NPI Number Information
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NPI Number | 1821069980
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Entity Type | Individual
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Provider Name | MELANIE RENEE SHAW KOVARIK ARNP, BC
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Gender | Female
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 1400 E NORTH AVE
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City | BELTON
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State | MO
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Zip | 64012-5110
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Country | US
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Telephone | 866-825-3227
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Fax |
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Provider Business Mailing Address
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Address Line | 329 SE CANTER CIR
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City | LEES SUMMIT
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State | MO
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Zip | 64082-8218
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Country | US
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Telephone | 816-366-0063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 14-80040-071
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 096676
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 45403
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 096676
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License Number State | MO
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