Provider Demographics
NPI:1982471793
Name:DEAN, MELISSA K (CNM)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:DEAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:K
Other - Last Name:MERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1213 WESTMORELAND RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4858
Mailing Address - Country:US
Mailing Address - Phone:719-394-9779
Mailing Address - Fax:719-687-9519
Practice Address - Street 1:1213 WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4858
Practice Address - Country:US
Practice Address - Phone:719-437-7649
Practice Address - Fax:719-687-9519
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT349786-4402367A00000X
COC-APN.0102488-C-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife