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General NPI Number Information
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NPI Number | 1902260144
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Entity Type | Individual
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Provider Name | ELIZABETH MELTON APRN
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Gender | Female
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 3889 S JACKSON DR
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City | INDEPENDENCE
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State | MO
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Zip | 64057-1927
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Country | US
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Telephone | 816-698-8290
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Fax |
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Provider Business Mailing Address
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Address Line | 3889 S JACKSON DR
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City | INDEPENDENCE
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State | MO
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Zip | 64057-1927
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Country | US
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Telephone | 816-698-8290
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Fax | 816-698-8291
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2016011314
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License Number State | MO
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