Provider Demographics
NPI:1891021416
Name:SHIMMIN, MELINDA SUE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:SUE
Last Name:SHIMMIN
Suffix:
Gender:F
Credentials:CNP
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Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:KH FAMILY HEALTH CLINIC
Mailing Address - City:KEWANEE
Mailing Address - State:IL
Mailing Address - Zip Code:61443-0747
Mailing Address - Country:US
Mailing Address - Phone:309-852-7700
Mailing Address - Fax:309-852-7764
Practice Address - Street 1:1051 W SOUTH ST
Practice Address - Street 2:KH FAMILY HEALTH CLINIC
Practice Address - City:KEWANEE
Practice Address - State:IL
Practice Address - Zip Code:61443-8354
Practice Address - Country:US
Practice Address - Phone:309-852-7700
Practice Address - Fax:309-852-7764
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2019-04-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209007870363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily