Provider Demographics
NPI:1437374832
Name:BAILEY, MELINDA K (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:K
Last Name:BAILEY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:K
Other - Last Name:GOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:3200 S KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-5355
Mailing Address - Country:US
Mailing Address - Phone:918-225-3336
Mailing Address - Fax:918-223-2937
Practice Address - Street 1:138 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:OK
Practice Address - Zip Code:74331-0705
Practice Address - Country:US
Practice Address - Phone:918-257-8029
Practice Address - Fax:918-257-8042
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0032158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily