Provider Demographics
NPI: | 1598929333 |
---|---|
Name: | MELTON, AIMEE (CNM) |
Entity type: | Individual |
Prefix: | |
First Name: | AIMEE |
Middle Name: | |
Last Name: | MELTON |
Suffix: | |
Gender: | F |
Credentials: | CNM |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1805 SHEA CENTER DR STE 301 |
Mailing Address - Street 2: | |
Mailing Address - City: | HIGHLANDS RANCH |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80129-2277 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-738-1100 |
Mailing Address - Fax: | 303-738-1310 |
Practice Address - Street 1: | 7780 S BROADWAY STE 280 |
Practice Address - Street 2: | |
Practice Address - City: | LITTLETON |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80122-2633 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-738-1100 |
Practice Address - Fax: | 303-738-1310 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-07-10 |
Last Update Date: | 2022-09-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | 5524 | 176B00000X |
CO | APN.0005524-CNM | 367A00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | |
No | 176B00000X | Other Service Providers | Midwife |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CO | 17906750 | Medicaid | |
CO | CO305060 | Medicare PIN | |
CO | CO301077 | Medicare PIN |