Healthcare Provider Details

I. General information

NPI: 1528925120
Provider Name (Legal Business Name): BRIAUNNA N MELCHOR FNP- C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4773 N 20TH ST STE B23
PHOENIX AZ
85016-4706
US

IV. Provider business mailing address

10922 W ASHBROOK PL
AVONDALE AZ
85392-3710
US

V. Phone/Fax

Practice location:
  • Phone: 480-674-8268
  • Fax:
Mailing address:
  • Phone: 602-301-5265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number233054
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: