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NPI Code Detail

MEDICARE: MELISSA WENDL RN

MEDICARE:   MELISSA  WENDL  RN
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
1163W00000XRegistered NurseRN207921AZ

General Provider Information

NPI Number : 1780472381
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA WENDL RN
Provider Business Mailing Address
First Line : 4165 BIG BEND ST
Second Line :
City : SIERRA VISTA
State : AZ
Zip : 85650-7027
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4165 BIG BEND ST
Second Line :
City : SIERRA VISTA
State : AZ
Zip : 85650-7027
Country : US
Telephone Number : 937-838-5103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2025
Last Update Date : 04/25/2025

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