Provider Demographics
NPI:1902236227
Name:MELTON, TRISTENA (RN, CPNP)
Entity type:Individual
Prefix:
First Name:TRISTENA
Middle Name:
Last Name:MELTON
Suffix:
Gender:
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN STE C300J
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2604
Mailing Address - Country:US
Mailing Address - Phone:972-566-7730
Mailing Address - Fax:972-566-7437
Practice Address - Street 1:7777 FOREST LN STE C300J
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2604
Practice Address - Country:US
Practice Address - Phone:972-566-7730
Practice Address - Fax:972-566-7437
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124621363L00000X, 363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner