Provider Demographics
NPI:1154800332
Name:KERN, MELODY K (ARNP)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:K
Last Name:KERN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:715 W 1ST ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2617
Mailing Address - Country:US
Mailing Address - Phone:319-961-1771
Mailing Address - Fax:319-575-6059
Practice Address - Street 1:715 W 1ST ST STE 2
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2617
Practice Address - Country:US
Practice Address - Phone:319-961-1771
Practice Address - Fax:319-575-6059
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAA13708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0076372Medicaid