Provider Demographics
NPI:1447926142
Name:MELENDEZ, MAYRA (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N MESA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3554
Mailing Address - Country:US
Mailing Address - Phone:915-577-9900
Mailing Address - Fax:
Practice Address - Street 1:1800 N MESA ST STE 200
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3554
Practice Address - Country:US
Practice Address - Phone:915-577-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-22
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145504363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily