Healthcare Provider Details

I. General information

NPI: 1568355337
Provider Name (Legal Business Name): MELISSA WAFIZA HUSSAIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6709 ACADEMY RD NE STE A
ALBUQUERQUE NM
87109-3363
US

IV. Provider business mailing address

19714 WYNDHAM LAKES DR
ODESSA FL
33556-1704
US

V. Phone/Fax

Practice location:
  • Phone: 505-308-3145
  • Fax: 505-308-3147
Mailing address:
  • Phone: 813-841-4820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number89984
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: