=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366279820
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELVA ESTRADA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2024
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 JARRETT WHITE RD BEHAVIOR HEALTH MULTI-D
-----------------------------------------------------
City | TRIPLER AMC
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96859-4712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-844-1523
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 JARRETT WHITE RD BEHAVIOR HEALTH MULTI-D
-----------------------------------------------------
City | TRIPLER AMC
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96859-4712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-844-1523
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ15014500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 405920
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | SP026963
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------