Provider Demographics
NPI:1164453536
Name:RUHLMANN, MELINDA L (CNM)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:L
Last Name:RUHLMANN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:RUHLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:ATTN. CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3305
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:1886 W 800 N
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-4097
Practice Address - Country:US
Practice Address - Phone:801-756-5255
Practice Address - Fax:801-756-5289
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2176474402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
S63428Medicare UPIN