MEDICARE: MELANIE THELEN PA-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	363A00000X	Physician Assistant	201068	AK
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1609544121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE THELEN PA-C

Provider Business Mailing Address
First Line	:	3851 PIPER ST STE U466
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-6905
Country	:	US
Telephone Number	:	907-569-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	3851 PIPER ST STE U466
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-6905
Country	:	US
Telephone Number	:	907-569-1433
Fax Number	:

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

Provider Enumeration Date	:	08/31/2021
Last Update Date	:	01/14/2026

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Directions to “ MELANIE THELEN PA-C” Practice Location

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