Provider Demographics
NPI:1063596765
Name:MELHUISH, VICTORIA LYNN (DPM)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:MELHUISH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 S CARSON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-4530
Mailing Address - Country:US
Mailing Address - Phone:775-783-8037
Mailing Address - Fax:775-782-3787
Practice Address - Street 1:2350 S CARSON ST STE 3
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-4530
Practice Address - Country:US
Practice Address - Phone:775-783-8037
Practice Address - Fax:775-782-3787
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9505213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU53988Medicare UPIN
NVV33773Medicare PIN
CA000E38940Medicare PIN