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Individual

MELINDA A PRESTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
16601 N 40TH ST, SUITE 101, PHOENIX, AZ 85032-3345
(480) 251-8689
(602) 795-2608
Mailing address
1335 E ELLIS DR, TEMPE, AZ 85282-7261
(480) 251-8689

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP0004
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
398306
AZ
01
500002997
RAILROAD MEDICARE
AZ
01
86080015085259A380
TRIWEST
AZ
01
Z128624
PTAN
AZ
Enumeration date
11/22/2005
Last updated
08/26/2011
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