Provider Demographics
NPI:1922845817
Name:ISAACS-MENDELSOHN, MELANIE ANN PATRICIA
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN PATRICIA
Last Name:ISAACS-MENDELSOHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ANN PATRICIA
Other - Last Name:ISAACS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:41978 W MONTEVERDE CT
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-3696
Mailing Address - Country:US
Mailing Address - Phone:520-560-3561
Mailing Address - Fax:
Practice Address - Street 1:19896 N LAUREN RD
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-6075
Practice Address - Country:US
Practice Address - Phone:602-637-4331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN134237163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice