Provider Demographics
NPI:1912339078
Name:WARD, MELANIE J (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:J
Last Name:WARD
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:J
Other - Last Name:HEAIRLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5063 S COTTONWOOD ST STE 120
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6772
Mailing Address - Country:US
Mailing Address - Phone:801-507-1800
Mailing Address - Fax:
Practice Address - Street 1:5063 S COTTONWOOD ST STE 120
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6772
Practice Address - Country:US
Practice Address - Phone:801-507-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8569664-8900363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health