MEDICARE: MELANIE MANUEL FNP-BC

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	363LF0000X	Family Nurse Practitioner	864101	NV

General Provider Information

NPI Number	:	1437830668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE MANUEL FNP-BC

Provider Business Mailing Address
First Line	:	3089 AZURE BAY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2572
Country	:	US
Telephone Number	:	702-580-3875
Fax Number	:

Provider Business Practice Location Address
First Line	:	5625 LOSEE RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-2523
Country	:	US
Telephone Number	:	702-552-1818
Fax Number	:	702-968-8637

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

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	11/11/2025

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