Provider Demographics
NPI:1427851476
Name:RENKEN, MELANIE
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:RENKEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:KS
Mailing Address - Zip Code:67457-0455
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:440 STATE ST
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:KS
Practice Address - Zip Code:67457-9107
Practice Address - Country:US
Practice Address - Phone:620-897-6266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant