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General NPI Number Information
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NPI Number | 1063240646
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Entity Type | Individual
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Provider Name | MELISSA VELASQUEZ
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Gender | Female
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 6636 W SUNSET AVE STE A
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City | SPRINGDALE
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State | AR
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Zip | 72762-0971
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Country | US
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Telephone | 479-361-4631
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 W HUDSON RD
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City | ROGERS
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State | AR
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Zip | 72756-2334
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Country | US
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Telephone | 479-250-8672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 229882
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License Number State | AR
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