Individual
MELINA MONCIVAIZ
Active
Individual
MELINA MONCIVAIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1016766
TX
363LP0200X
Pediatric Nurse Practitioner
209-016879
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
11/15/2017
Last updated
07/01/2021
Update your record
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