Provider Demographics
NPI:1235414145
Name:KING, MELANIE (RN, MSN ACNP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:RN, MSN ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 HIGHWAY 6 E
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-3002
Mailing Address - Country:US
Mailing Address - Phone:662-563-8703
Mailing Address - Fax:662-563-7736
Practice Address - Street 1:590 HIGHWAY 6 E
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-3002
Practice Address - Country:US
Practice Address - Phone:662-563-8703
Practice Address - Fax:662-563-7736
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS851239363L00000X, 363LP0808X
MSR851239363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care