=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417205683
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISA ARREGUIN FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2012
-----------------------------------------------------
Last Update Date | 08/20/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1101 N CHERRY ST
-----------------------------------------------------
City | TULARE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93274-2231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-686-9097
-----------------------------------------------------
Fax | 559-686-1562
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1201 N CHERRY ST
-----------------------------------------------------
City | TULARE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93274-2233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-686-9097
-----------------------------------------------------
Fax | 559-686-1562
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 22062
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------