Active NPI
Amanda Melin, NP
- Primary Care Nurse Practitioner
- Mankato, MN
National Provider Identifier
1104388222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 6110
- Practice address
- 1025 Marsh St
Mankato, MN 56001-4752 - Phone
- (507) 594-4863
- NPI assigned
- Apr 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 6110 | MN | Primary |
Addresses
Primary practice location
1025 Marsh St
Mankato, MN 56001-4752
Mailing address
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 594-4863
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6110 | MN | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554508800000",
"number": "1104388222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 MARSH ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560014752",
"telephone_number": "507-594-4863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 MARSH ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560014752",
"telephone_number": "507-594-4863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELIN",
"first_name": "AMANDA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-06",
"last_updated": "2019-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MN",
"license": "6110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.