MEDICARE: MRS. MELANIE BURRIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	1161	KS

General Provider Information

NPI Number	:	1073205498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELANIE BURRIS

Provider Business Mailing Address
First Line	:	14237 W 120TH TER
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-6035
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8247 LEAVENWORTH RD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-1574
Country	:	US
Telephone Number	:	913-703-4037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2023
Last Update Date	:	05/24/2023

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Directions to “ MRS. MELANIE BURRIS ” Practice Location

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