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General NPI Number Information
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NPI Number | 1720684376
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Entity Type | Individual
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Provider Name | TAHA JEJIN MELCHOR NONOG APRN, AG-ACNP-BP
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Gender | Male
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 1500 S DALLAS PKWY
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City | CELINA
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State | TX
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Zip | 75009-3495
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Country | US
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Telephone | 469-204-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 S DALLAS PKWY
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City | CELINA
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State | TX
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Zip | 75009-3495
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Country | US
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Telephone | 469-204-2021
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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 | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | 1056301
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License Number State | TX
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