Basic Information
| Provider Information | |||||||||
| NPI: | 1144296930 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FROST | ||||||||
| FirstName: | MELINDA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 S MINNESOTA AVE | ||||||||
| Address2: | STE 100 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571053762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1325 S CLIFF AVE | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227905 | ||||||||
| FaxNumber: | 6053228414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 12/20/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | CP000286 | SD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 4995296 | 01 | SD | BLUE CROSS | OTHER | HP43476 | 01 | SD | HEALTHPARTNERS | OTHER | 370624200 | 01 | SD | DEPT OF LABOR | OTHER | 46022474347 | 05 | NE | MEDICAID | 502T2FR | 01 | MN | CC SYSTEMS/ BLUE PLUS | OTHER | 92411422905 | 01 | MN | PRIMEWEST | OTHER | 0118715 | 01 | SD | MEDICA | OTHER | 6827410 | 05 | SD | MEDICAID | 2177212 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 6827414 | 05 | SD | MEDICAID | 9237766 | 01 | SD | DAKOTACARE | OTHER | 244214 | 01 | SD | MIDLANDS CHOICE | OTHER | 0584508 | 05 | IA | MEDICAID | 36787 | 01 | SD | SANFORD HEALTH PLAN | OTHER | 57105W007 | 01 | SD | WPS TRICARE | OTHER | 407141041933 | 01 | SD | PREFERRED ONE | OTHER | 502T2FR | 01 | MN | BLUE CROSS | OTHER | 871496700 | 05 | MN | MEDICAID |