Provider Demographics
NPI:1750618807
Name:KAUFMAN, MELANIE L (CNM, ARNP)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:L
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:L
Other - Last Name:LINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP, CNM
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:4030 W BOY SCOUT BLVD STE 800
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5713
Practice Address - Country:US
Practice Address - Phone:813-286-0033
Practice Address - Fax:813-282-1806
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1179363L00000X
FLAPRN11023454363LW0102X
CORN.1627639163W00000X
IA102071363L00000X
COAPN.0991235-CNM367A00000X
SDCM000050367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6540340Medicaid
IA0057570Medicaid
SD6540340Medicaid
IA05757Medicare PIN