Healthcare Provider Details

I. General information

NPI: 1982103586
Provider Name (Legal Business Name): MELISSA M CARDENAS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2018
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10515 W SANTA FE DR
SUN CITY AZ
85351-3020
US

IV. Provider business mailing address

10515 W SANTA FE DR
SUN CITY AZ
85351-3020
US

V. Phone/Fax

Practice location:
  • Phone: 623-832-6530
  • Fax: 623-832-6504
Mailing address:
  • Phone: 623-832-6530
  • Fax: 623-832-6504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN145115
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11300
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: