Melissa Penn, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

3008763 Issued in KY

Practice address

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Phone

(505) 722-1000

NPI assigned

Sep 7, 2014

Last updated

Sep 7, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410048000000",
    "number": "1720489933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516A W MESA AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873016466",
            "telephone_number": "502-327-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "MELISSA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-07",
        "last_updated": "2014-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "KY",
            "license": "3008763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Medical Gallup, LLC (McKinley Center)
• William Clay Pearson, M.S.
• Viola R Peina
• Regine Francine Penda Ewanga
• Alicia Marie Pender, RN
• Kevin Dale Perdue, M.D.
• Karen Pereira, RN
• Clark Perez, RN
• Gabe E. Perez, COTA
• Krisnna E Perez, RN

• Advanced Practice Midwife in Gallup, NM
• Providers in Gallup, NM by specialty
• Advanced Practice Midwife in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.