Individual
MELANIE J MCNUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS-SLP
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
682
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4600983
MEDICA #
ND
01
—
4600984
MEDICA #
ND
05
—
51418
—
ND
01
—
HP31697
HEALTHPARTNERS #
ND
Enumeration date
06/26/2006
Last updated
05/23/2012
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