Provider Demographics
NPI:1194496026
Name:MELENDEZ, KRISTIN (RN, MSN)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 S SAINT THOMAS AQUINAS DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-7418
Mailing Address - Country:US
Mailing Address - Phone:520-891-5470
Mailing Address - Fax:
Practice Address - Street 1:4567 W. TETAKUSIM R.D
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746
Practice Address - Country:US
Practice Address - Phone:520-838-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ218640163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse