Individual
MELANIE BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 NOVELL PL, PROVO, UT 84606-6171
(801) 494-9236
Mailing address
1800 NOVELL PL, PROVO, UT 84606-6171
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
12302792-3102
UT
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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