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NPI Code Detail

MEDICARE: MELISSA MARIE TUNGATE APRN

MEDICARE: MELISSA MARIE TUNGATE 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
1363LG0600XGerontology Nurse Practitioner53-75896-102KS
2363LA2100XAcute Care Nurse Practitioner53-75896-102KS

General Provider Information

NPI Number : 1982047064
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MARIE TUNGATE APRN
Provider Business Mailing Address
First Line : 310 S HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67211-2129
Country : US
Telephone Number : 316-264-3505
Fax Number : 316-264-0908
Provider Business Practice Location Address
First Line : 310 S HILLSIDE ST
Second Line :
City : WICHITA
State : KS
Zip : 67211-2129
Country : US
Telephone Number : 316-264-3505
Fax Number : 316-264-0908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2013
Last Update Date : 03/17/2026

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