Provider Demographics
NPI:1477978054
Name:MELTON, WHITNEY (CNP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:MELTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-8820
Mailing Address - Country:US
Mailing Address - Phone:870-698-1635
Mailing Address - Fax:870-793-3196
Practice Address - Street 1:3443 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-8820
Practice Address - Country:US
Practice Address - Phone:870-698-1635
Practice Address - Fax:870-793-3196
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004035363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily