MEDICARE: BRIAUNNA N MELCHOR FNP- C

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	233054	AZ

General Provider Information

NPI Number	:	1528925120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAUNNA N MELCHOR FNP- C

Provider Business Mailing Address
First Line	:	10922 W ASHBROOK PL
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85392-3710
Country	:	US
Telephone Number	:	602-301-5265
Fax Number	:

Provider Business Practice Location Address
First Line	:	4773 N 20TH ST STE B23
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4706
Country	:	US
Telephone Number	:	480-674-8268
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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