Healthcare Provider Details

I. General information

NPI: 1548805369
Provider Name (Legal Business Name): MELISSA TIJERINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2019
Last Update Date: 11/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 HILLTOP RD
BATTLE MTN NV
89820-3406
US

IV. Provider business mailing address

1005 TERMINAL WAY STE 125
RENO NV
89502-2198
US

V. Phone/Fax

Practice location:
  • Phone: 775-455-6070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: