MEDICARE: MRS. MELANIE KRISTIN SUTTON APRN

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	363L00000X	Nurse Practitioner	A002997	AR

General Provider Information

NPI Number	:	1770695223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELANIE KRISTIN SUTTON APRN

Provider Business Mailing Address
First Line	:	4600 MERCY LN STE 210
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-3070
Country	:	US
Telephone Number	:	479-347-3809
Fax Number	:	479-338-4607

Provider Business Practice Location Address
First Line	:	4600 MERCY LN STE 210
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-3070
Country	:	US
Telephone Number	:	479-347-3809
Fax Number	:	479-338-4607

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/15/2022

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