Provider Demographics
NPI:1932556537
Name:HAUSS, MELINDA
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:HAUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16752 N GREASEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-3639
Mailing Address - Country:US
Mailing Address - Phone:623-584-4999
Mailing Address - Fax:623-215-0177
Practice Address - Street 1:16752 N GREASEWOOD ST
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-3639
Practice Address - Country:US
Practice Address - Phone:623-584-4999
Practice Address - Fax:623-215-0177
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN136577163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse