MEDICARE: MRS. MELISSA ANN ANTOGNINI WHNP

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	RN117634	AZ

General Provider Information

NPI Number	:	1851568158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA ANN ANTOGNINI WHNP

Provider Business Mailing Address
First Line	:	14220 NORTHSIGHT BLVD
Second Line	:	SUITE 150
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-3950
Country	:	US
Telephone Number	:	480-585-0804
Fax Number	:	480-585-0828

Provider Business Practice Location Address
First Line	:	14220 NORTHSIGHT BLVD
Second Line	:	SUITE 150
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-3950
Country	:	US
Telephone Number	:	480-585-0804
Fax Number	:	480-585-0828

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

Provider Enumeration Date	:	05/15/2008
Last Update Date	:	08/31/2011

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