Provider Demographics
NPI:1972586865
Name:WELLS, MELINDA S (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:S
Last Name:WELLS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:S
Other - Last Name:KEBERLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15607 W 125TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-4991
Mailing Address - Country:US
Mailing Address - Phone:785-483-3333
Mailing Address - Fax:785-483-4859
Practice Address - Street 1:2090 W DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-6869
Practice Address - Country:US
Practice Address - Phone:913-856-8300
Practice Address - Fax:913-856-8711
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-45053363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100643160BMedicaid
KS460844OtherCHILDRENS MERCY
KS110498OtherBCBS
KS110498OtherBCBS
Q03329Medicare UPIN