Healthcare Provider Details

I. General information

NPI: 1639677289
Provider Name (Legal Business Name): MELISSA J COMETTI DNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735 NORTHRISE DR STE B
LAS CRUCES NM
88011-0897
US

IV. Provider business mailing address

2735 NORTHRISE DR STE B
LAS CRUCES NM
88011-0897
US

V. Phone/Fax

Practice location:
  • Phone: 575-532-4399
  • Fax: 575-532-4433
Mailing address:
  • Phone: 575-532-4399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-03479
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: