Basic Information
Provider Information
NPI: 1972014181
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SALINE
FirstName: MELISSA
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PRINGLE
OtherFirstName: MELISSA
OtherMiddleName: MARIE
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 1
Mailing Information
Address1: 1460 E 250TH RD
Address2:  
City: LECOMPTON
State: KS
PostalCode: 660504082
CountryCode: US
TelephoneNumber: 7854243431
FaxNumber:  
Practice Location
Address1: 2200 SW GAGE BLVD
Address2:  
City: TOPEKA
State: KS
PostalCode: 666220001
CountryCode: US
TelephoneNumber: 7853503111
FaxNumber: 7853504336
Other Information
ProviderEnumerationDate: 10/14/2017
LastUpdateDate: 10/14/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X13-27751-022KSY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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