Provider Demographics
NPI:1588391775
Name:RODRIGUEZ, MELINDA ANN (APRN)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:USZUKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4530 S DECATUR BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-5239
Mailing Address - Country:US
Mailing Address - Phone:725-726-2660
Mailing Address - Fax:
Practice Address - Street 1:4530 S DECATUR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-5239
Practice Address - Country:US
Practice Address - Phone:725-726-2660
Practice Address - Fax:725-726-2674
Is Sole Proprietor?:No
Enumeration Date:2022-08-06
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV854799363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner