MEDICARE: MRS. MELANIE ANN NUGENT CPNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	AP4532	AZ

General Provider Information

NPI Number	:	1003162108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELANIE ANN NUGENT CPNP

Provider Business Mailing Address
First Line	:	22044 N 44TH ST STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-6104
Country	:	US
Telephone Number	:	602-257-7673
Fax Number	:	602-257-7344

Provider Business Practice Location Address
First Line	:	22044 N 44TH ST STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-6104
Country	:	US
Telephone Number	:	602-257-7673
Fax Number	:	602-257-7344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2012
Last Update Date	:	03/13/2026

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