Melinda Cecile Ekholm, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30005591 Issued in WA

Practice address

3994 Colville Rd
Loon Lake, WA 99148-9789

Phone

(509) 233-8412

Fax

(509) 233-2864

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Melinda C Elledge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1912008988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3994 COLVILLE RD",
            "address_2": "PO BOX 303",
            "city": "LOON LAKE",
            "state": "WA",
            "postal_code": "991489789",
            "telephone_number": "509-233-8412",
            "fax_number": "509-233-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3994 COLVILLE RD",
            "city": "LOON LAKE",
            "state": "WA",
            "postal_code": "991489789",
            "telephone_number": "509-233-8412",
            "fax_number": "509-233-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKHOLM",
        "first_name": "MELINDA",
        "middle_name": "CECILE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30005591",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "RN00082739",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9629320",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES ID #",
            "identifier": "143010",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "ELLEDGE",
            "middle_name": "C",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Naomi Carrasco
• Paul Frederic Davis, D.D.S.
• Divinity LLC (Divinity)
• Here to Help Homecare, LLC (Enable)
• Brenda Michele Hughbanks, MA 60040625
• Loon Lake School District #183
• New Health Programs Association (NEW Health Loon Lake Medical)
• Robert John Peterson, LICSW

• Family Nurse Practitioner in Loon Lake, WA
• Providers in Loon Lake, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.