Provider Demographics
NPI:1346531860
Name:KABOT-STUROS, MELANIE M (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:M
Last Name:KABOT-STUROS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 S 6TH ST STE 217
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-7112
Mailing Address - Country:US
Mailing Address - Phone:541-668-8600
Mailing Address - Fax:
Practice Address - Street 1:300 CRATER LAKE AVE STE 201
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6604
Practice Address - Country:US
Practice Address - Phone:541-826-0899
Practice Address - Fax:541-826-2234
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200642237RN163WP0807X
OR201150137NP163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent