MEDICARE: MS. MELINDA JANINE ARMSTRONG PHYSICIAN ASSISTANT

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	363A00000X	Physician Assistant	003870	GA
2	363A00000X	Physician Assistant	AMD-693	HI
3	363AM0700X	Medical Physician Assistant	PA1089	NV
4	363AM0700X	Medical Physician Assistant	4418	AZ

General Provider Information

NPI Number	:	1558349928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELINDA JANINE ARMSTRONG PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	P.O. BOX 142465
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	KWAJALEIN HOSPITAL
Second Line	:
City	:	APO
State	:	AP
Zip	:	96555
Country	:	US
Telephone Number	:	805-355-2223
Fax Number	:

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	10/10/2016

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