MEDICARE: TAMI MELLINGER 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	RN020602	MT

General Provider Information

NPI Number	:	1396896569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMI MELLINGER FNP-C

Provider Business Mailing Address
First Line	:	5112 4TH AVE N APT 4
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-1338
Country	:	US
Telephone Number	:	406-750-8776
Fax Number	:	406-727-0007

Provider Business Practice Location Address
First Line	:	2230 N RESERVE ST STE 110
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-1364
Country	:	US
Telephone Number	:	406-926-5111
Fax Number	:

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	10/31/2025

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