Provider Demographics
NPI:1215150917
Name:MELENDEZ, JOAN M (RN)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:M
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85607-2742
Mailing Address - Country:US
Mailing Address - Phone:520-364-4721
Mailing Address - Fax:
Practice Address - Street 1:2200 E 11TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-2738
Practice Address - Country:US
Practice Address - Phone:520-364-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN034302163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool