Individual
STEPHANIE MELROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4880 WYNN RD, LAS VEGAS, NV 89103-5406
(702) 871-5005
(702) 871-1349
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3139
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235957549
—
NV
01
—
PA3139
STATE LICENSE
NV
Enumeration date
09/26/2024
Last updated
04/24/2026
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