Provider Demographics
NPI:1336684539
Name:ZIELKE, MELANIE KATE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:KATE
Last Name:ZIELKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 ABBEY RD
Mailing Address - Street 2:APT. # 612
Mailing Address - City:EVANS
Mailing Address - State:CO
Mailing Address - Zip Code:80620-8608
Mailing Address - Country:US
Mailing Address - Phone:815-388-3036
Mailing Address - Fax:
Practice Address - Street 1:1300 N 17TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-9584
Practice Address - Country:US
Practice Address - Phone:970-347-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONA.00760162376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide