MEDICARE: MELANIE SANTANA

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	231H00000X	Audiologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144941030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE SANTANA

Provider Business Mailing Address
First Line	:	5229 WILD SUNFLOWER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-4037
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5229 WILD SUNFLOWER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-4037
Country	:	US
Telephone Number	:	702-600-9203
Fax Number	:

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

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	09/08/2022

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Directions to “ MELANIE SANTANA ” Practice Location

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