Individual
MRS. MELANIE RENEE SHAW KOVARIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP, BC
Contact information
Practice address
1400 E NORTH AVE, BELTON, MO 64012-5110
(866) 825-3227
Mailing address
329 SE CANTER CIR, LEES SUMMIT, MO 64082-8218
(816) 366-0063
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
096676
MO
163WG0000X
General Practice Registered Nurse
14-80040-071
KS
363LF0000X
Family Nurse Practitioner
Primary
096676
MO
363LF0000X
Family Nurse Practitioner
45403
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201019551
—
MO
Enumeration date
01/27/2006
Last updated
03/16/2011
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