Individual
MELODIE ANNE KABANUK DOHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP, PMHNP
Contact information
Practice address
2704 MOUNDS VIEW BLVD STE 12, SAINT PAUL, MN 55112-4366
(320) 232-0647
(567) 205-3614
Mailing address
2704 MOUNDS VIEW BLVD STE 12, SAINT PAUL, MN 55112-4366
(320) 232-0647
(567) 205-3614
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6419
MN
Other
Enumeration date
02/13/2019
Last updated
11/10/2025
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