Mellick, Jennifer Rebecca

Mellick, Jennifer Rebecca is an individual health care provider with primary practice located at 7301 W 133Rd St Suite 102, Overland Park KS 66213-4750. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Mellick, Jennifer Rebecca can be contacted via phone (913) 888-4567.

Contact Information

Primary practice address
7301 W 133Rd St Suite 102 Overland Park KS 66213-4750
Phone: (913) 888-4567
Fax: (913) 888-1277
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 04-30373 Kansas

Profile Details

NPI number 1093712903
LBN Legal business name Mellick, Jennifer Rebecca
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Dec 7th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093712903 NPPES
Kansas Other 33978014 BCBSKC PROVIDER NUMBER

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