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Individual

MELINDA ROSE VICKERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
10460 N 92ND ST STE 300, SCOTTSDALE, AZ 85258-4547
(480) 323-1573
Mailing address
10460 N 92ND ST STE 300, SCOTTSDALE, AZ 85258-4547
(480) 323-1573

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10929
AZ
363A00000X
Physician Assistant
PA14229
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
422835501
TX
01
422835502
MEDICAID-CSHCN
TX
01
Q00083234
RAILROAD MEDICARE
TX
Enumeration date
12/22/2020
Last updated
03/05/2025
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