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Individual

MRS. MELISSA A ACQUAVIVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 779-3366
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209035977
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
251083
AZ
367500000X
Certified Registered Nurse Anesthetist
CR000769
SD

Other

Enumeration date
12/08/2006
Last updated
07/01/2026
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