MEDICARE: MELISSA SUE STRANG FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	218193	AZ
2	363LF0000X	Family Nurse Practitioner	RN162691	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750850830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA SUE STRANG FNP

Provider Business Mailing Address
First Line	:	3805 E BELL RD STE 3100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2136
Country	:	US
Telephone Number	:	602-494-3656
Fax Number	:	602-867-3862

Provider Business Practice Location Address
First Line	:	19646 N 27TH AVE STE 408
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-4028
Country	:	US
Telephone Number	:	602-867-8644
Fax Number	:	602-606-5128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2018
Last Update Date	:	06/29/2022

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Directions to “ MELISSA SUE STRANG FNP” Practice Location

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