MEDICARE: MELANIE J WARD WHNP-BC

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	363LW0102X	Women's Health Nurse Practitioner	8569664-8900	UT

General Provider Information

NPI Number	:	1912339078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE J WARD WHNP-BC

Provider Business Mailing Address
First Line	:	5063 S COTTONWOOD ST STE 120
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-6772
Country	:	US
Telephone Number	:	801-507-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	5063 S COTTONWOOD ST STE 120
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-6772
Country	:	US
Telephone Number	:	801-507-1800
Fax Number	:

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

Provider Enumeration Date	:	07/31/2013
Last Update Date	:	05/26/2020

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