Individual
MELAINA ZANELE BLOMENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3269 STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-2101
Mailing address
410 BRITE DR, LAKE HAVASU CITY, AZ 86406-7088
(928) 854-2542
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2731
AZ
Other
Enumeration date
07/22/2006
Last updated
06/30/2009
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