Provider Demographics
NPI:1396504130
Name:REDE, MELANIE (MA)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:
Last Name:REDE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 W HORIZON RIDGE PKWY APT 111
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5507
Mailing Address - Country:US
Mailing Address - Phone:208-680-5476
Mailing Address - Fax:
Practice Address - Street 1:2850 LINDELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6815
Practice Address - Country:US
Practice Address - Phone:702-969-9731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program