Individual
MELISSA FAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
14010 N NORTHSIGHT BLVD, SCOTTSDALE, AZ 85260-3601
(480) 223-4112
Mailing address
14010 N NORTHSIGHT BLVD, SCOTTSDALE, AZ 85260-3601
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
4168
GA
363AM0700X
Medical Physician Assistant
4657
AZ
363AM0700X
Medical Physician Assistant
Primary
9103262
FL
363AM0700X
Medical Physician Assistant
PA575
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292965100
—
FL
Enumeration date
11/12/2007
Last updated
03/05/2014
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