Provider Demographics
NPI:1083947253
Name:MCCARVILLE, MELANIE ELISABETH (LPN)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:ELISABETH
Last Name:MCCARVILLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:ELISABETH
Other - Last Name:MCCARVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1946 E HEDRICK DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2419
Mailing Address - Country:US
Mailing Address - Phone:520-991-4345
Mailing Address - Fax:
Practice Address - Street 1:1946 E HEDRICK DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2419
Practice Address - Country:US
Practice Address - Phone:520-991-4345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-06
Last Update Date:2009-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP034909164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse