Healthcare Provider Details

I. General information

NPI: 1992729586
Provider Name (Legal Business Name): KAREN F MELOT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 W RAY ST
SUPERIOR AZ
85173-4124
US

IV. Provider business mailing address

454 W RAY ST
SUPERIOR AZ
85173-4124
US

V. Phone/Fax

Practice location:
  • Phone: 480-660-5913
  • Fax:
Mailing address:
  • Phone: 480-660-5913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberNPF10648
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNPF10648
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP10648
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNP10648
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP10648
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337947
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: