Provider Demographics
NPI:1295708121
Name:SCANTLING, MELINDA FAYE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:FAYE
Last Name:SCANTLING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:34929 ALMA LOU LN
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-5020
Mailing Address - Country:US
Mailing Address - Phone:918-649-7826
Mailing Address - Fax:
Practice Address - Street 1:714 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:HEAVENER
Practice Address - State:OK
Practice Address - Zip Code:74937-2253
Practice Address - Country:US
Practice Address - Phone:918-653-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0046658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP70286Medicare UPIN