Healthcare Provider Details

I. General information

NPI: 1235525072
Provider Name (Legal Business Name): MELISSA NUNTAPREDA KIRK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA NUNTAPREDA MD

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 SHARLANDS AVE
RENO NV
89523-2785
US

IV. Provider business mailing address

879 N MAIN ST
RICHFIELD UT
84701-1840
US

V. Phone/Fax

Practice location:
  • Phone: 801-712-8253
  • Fax:
Mailing address:
  • Phone: 801-712-8253
  • Fax: 435-896-9564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2019032297
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number10102335-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number27172
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: