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Individual

MELISSA LANZA BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
301 S UNION BLVD, COLORADO SPRINGS, CO 80910-3123
(719) 578-3249
Mailing address
27 MINNEHAHA AVE, MANITOU SPRINGS, CO 80829-1657
(719) 578-3249

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
99418
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07994189
CO
Enumeration date
02/27/2007
Last updated
07/08/2007
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