Provider Demographics
NPI:1033732284
Name:GARCIA, MELVIN ALEX (DNP, NP-C)
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:ALEX
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 RIVER RUN
Mailing Address - Street 2:
Mailing Address - City:GILBERTVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01031-8902
Mailing Address - Country:US
Mailing Address - Phone:540-641-7165
Mailing Address - Fax:
Practice Address - Street 1:1 GENERAL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2961
Practice Address - Country:US
Practice Address - Phone:978-683-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily