Active NPI
Melanie Johnston Henderson, NNP
- Neonatal Clinical Nurse Specialist
- Provo, UT
National Provider Identifier
1285927079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Clinical Nurse Specialist
- License
- 4926543-4405
- Practice address
- 1034 N 500 W
Provo, UT 84604-3380 - Phone
- (801) 357-7707
- NPI assigned
- May 26, 2011
- 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 |
|---|---|---|---|---|
| Neonatal Clinical Nurse Specialist | 364SN0000X | 4926543-4405 | UT | Primary |
Addresses
Primary practice location
1034 N 500 W
Provo, UT 84604-3380
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4926543-4405 | UT | MD | Neonatal Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515628800000",
"number": "1285927079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"fax_number": "801-226-0832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 N 500 W",
"city": "PROVO",
"state": "UT",
"postal_code": "846043380",
"telephone_number": "801-357-7707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "MELANIE",
"middle_name": "JOHNSTON",
"credential": "NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-26",
"last_updated": "2018-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "364SN0000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Neonatal",
"state": "UT",
"license": "4926543-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.