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NPI Code Detail

MEDICARE: MELANIE MARIE BLAIS ARNP

MEDICARE: MELANIE MARIE BLAIS ARNP
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
1363LA2200XAdult Health Nurse PractitionerH119417IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407890155
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE MARIE BLAIS ARNP
Provider Business Mailing Address
First Line : 1503 WASHINGTON DR
Second Line :
City : VINTON
State : IA
Zip : 52349-1654
Country : US
Telephone Number : 319-472-4053
Fax Number :
Provider Business Practice Location Address
First Line : 701 10TH ST SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-1292
Country : US
Telephone Number : 319-398-3804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 03/05/2019

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