Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | AP30006712 | WA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP30006712 | WA |
NPI | 1992734073 |
---|---|
Provider Name | Melody M Bemis |
First Address | Spokane, WA 99202-1510 |
Second Address | Spokane, WA 99202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 18/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1992734073 | (05) | WA |