Provider Demographics
NPI:1083948889
Name:WALKER, MELANIE ANN (NP-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:BICKHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2900 12TH AVE NORTH
Mailing Address - Street 2:SUITE 335W
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101
Mailing Address - Country:US
Mailing Address - Phone:406-237-8808
Mailing Address - Fax:406-237-8810
Practice Address - Street 1:2900 12TH AVE NORTH
Practice Address - Street 2:SUITE 335W
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101
Practice Address - Country:US
Practice Address - Phone:406-237-8808
Practice Address - Fax:406-237-8810
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT32167363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0750244Medicaid
MT0750244Medicaid