Provider Demographics
NPI:1578713392
Name:NORTON, MELINDA A (PA-C)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:A
Last Name:NORTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11338 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-3336
Mailing Address - Country:US
Mailing Address - Phone:913-248-8000
Mailing Address - Fax:913-248-8006
Practice Address - Street 1:11338 W 63RD ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-3336
Practice Address - Country:US
Practice Address - Phone:913-248-8000
Practice Address - Fax:913-248-8006
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST02322363A00000X
CAPA20474363A00000X
KS15-01287363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant