Provider Demographics
NPI:1740565704
Name:VOS, MELANI REAUME (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MELANI
Middle Name:REAUME
Last Name:VOS
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 1:5116 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079
Mailing Address - Country:US
Mailing Address - Phone:810-824-1779
Mailing Address - Fax:
Practice Address - Street 1:411 W LAKE LANSING RD
Practice Address - Street 2:SUITE C 120
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8445
Practice Address - Country:US
Practice Address - Phone:517-337-0957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006145363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical