Provider Demographics
NPI:1174018220
Name:HERNANDEZ, MELANIE NOEL (FNP-C)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:NOEL
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13624 W CAMINO DEL SOL STE 150
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-3405
Mailing Address - Country:US
Mailing Address - Phone:623-546-0203
Mailing Address - Fax:
Practice Address - Street 1:13624 W CAMINO DEL SOL STE 150
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-3405
Practice Address - Country:US
Practice Address - Phone:623-546-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11472363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily