MEDICARE: MRS. MELINDA MARIE WALDEN MSN, APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	50163	WY

General Provider Information

NPI Number	:	1124757794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELINDA MARIE WALDEN MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	234 E 1ST ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2516
Country	:	US
Telephone Number	:	866-678-4699
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 E 1ST ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2516
Country	:	US
Telephone Number	:	866-678-4699
Fax Number	:

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

Provider Enumeration Date	:	06/08/2022
Last Update Date	:	06/08/2022

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