Provider Demographics
NPI:1871213306
Name:YANQUI, MELISSA (BSN, RN, CCM)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:YANQUI
Suffix:
Gender:F
Credentials:BSN, RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9782 LARCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1691
Mailing Address - Country:US
Mailing Address - Phone:515-339-6791
Mailing Address - Fax:
Practice Address - Street 1:9782 LARCHWOOD DR
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1691
Practice Address - Country:US
Practice Address - Phone:515-339-6791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA133583163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management