Provider Demographics
NPI:1285735811
Name:YUNGER, MELANIE L (NP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:L
Last Name:YUNGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 411895
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1895
Mailing Address - Country:US
Mailing Address - Phone:913-632-2230
Mailing Address - Fax:913-632-2297
Practice Address - Street 1:9100 W 74TH ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-4004
Practice Address - Country:US
Practice Address - Phone:913-676-2301
Practice Address - Fax:913-789-3191
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45791363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS37507021OtherBCBS KC
KSP00973653OtherRR MEDICARE
KS200727250AMedicaid
KS143000024Medicare PIN