Provider Demographics
NPI:1629225545
Name:YANKE, MELANIE J (CNM, CPNP-PC, IBCLC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:J
Last Name:YANKE
Suffix:
Gender:F
Credentials:CNM, CPNP-PC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 CHARLESTON ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3608
Mailing Address - Country:US
Mailing Address - Phone:505-818-8040
Mailing Address - Fax:
Practice Address - Street 1:2720 CHARLESTON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3608
Practice Address - Country:US
Practice Address - Phone:505-818-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM68418163WL0100X, 363LP0200X
NM577367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics