Provider Demographics
NPI:1417222829
Name:HEGEDUS, MELISSA LYNNE (PA-C, MPH)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LYNNE
Last Name:HEGEDUS
Suffix:
Gender:F
Credentials:PA-C, MPH
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:LYNNE
Other - Last Name:PLOUVIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MPH
Mailing Address - Street 1:2090 W DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5002
Mailing Address - Country:US
Mailing Address - Phone:913-356-8300
Mailing Address - Fax:913-356-8711
Practice Address - Street 1:2090 W DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5002
Practice Address - Country:US
Practice Address - Phone:913-356-8300
Practice Address - Fax:913-356-8711
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018542363A00000X
KS15-02049363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant