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General NPI Number Information
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NPI Number | 1396069126
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Entity Type | Individual
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Provider Name | MELISA JO BLACHLY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 1880 W ORANGE GROVE RD
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City | TUCSON
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State | AZ
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Zip | 85704-1129
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Country | US
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Telephone | 520-689-6809
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Fax | 520-699-5201
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Provider Business Mailing Address
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Address Line | 1880 W ORANGE GROVE RD
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City | TUCSON
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State | AZ
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Zip | 85704-1129
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Country | US
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Telephone | 520-689-6809
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Fax | 520-699-5201
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 146735
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 221053
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License Number State | AZ
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