Provider Demographics
NPI:1528425659
Name:ZYCH, MELINDA H (PA-C)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:H
Last Name:ZYCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:H
Other - Last Name:HELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:3004 GORDONVILLE RD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5008
Practice Address - Country:US
Practice Address - Phone:573-332-1972
Practice Address - Fax:573-334-4667
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015041420363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant