Provider Demographics
NPI:1619140654
Name:NOE, MELODY KAY (P A)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:KAY
Last Name:NOE
Suffix:
Gender:F
Credentials:P A
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:KAY
Other - Last Name:FERRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C, MMS
Mailing Address - Street 1:8057 S TRENTON CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3207
Mailing Address - Country:US
Mailing Address - Phone:303-548-4350
Mailing Address - Fax:303-344-0200
Practice Address - Street 1:4101 W CONEJOS PL
Practice Address - Street 2:SUITE 225
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1377
Practice Address - Country:US
Practice Address - Phone:303-595-6765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2509363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical