Basic Information
| Provider Information | |||||||||
| NPI: | 1962860684 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | MELODY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | APRN-NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 CAMBRIDGE ST STE 2060 | ||||||||
| Address2: | MAILSTOP 2018 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661608501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135881227 | ||||||||
| FaxNumber: | 9135888005 | ||||||||
| Practice Location | |||||||||
| Address1: | 4000 CAMBRIDGE ST STE 2060 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661602358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135881227 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2016 | ||||||||
| LastUpdateDate: | 04/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 53-77182 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 2016003782 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LG0600X | 53-77182 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
ID Information
| ID | Type | State | Issuer | Description | 420029434 | 05 | MO | MEDICAID | 201233790B | 05 | KS | MEDICAID |