Individual
DR. MELANIE FLEUR SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1020 LAKEVIEW AVE, PUEBLO, CO 81004-3508
(719) 557-3660
(719) 557-3690
Mailing address
PO BOX 800022, KANSAS CITY, MO 64180-0022
(800) 953-0104
(303) 765-6670
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN.0995300-NP
CO
363LA2100X
Acute Care Nurse Practitioner
0178632
CO
363LA2200X
Adult Health Nurse Practitioner
0178632
CO
363LG0600X
Gerontology Nurse Practitioner
0178632
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000181288
—
CO
Enumeration date
11/19/2019
Last updated
12/15/2021
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