Provider Demographics
NPI:1235311861
Name:BADAHMAN, MELISSA A (FNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:BADAHMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:BRESETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5980 S COOPER RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5394
Mailing Address - Country:US
Mailing Address - Phone:480-704-3474
Mailing Address - Fax:888-221-2541
Practice Address - Street 1:5980 S COOPER RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-5394
Practice Address - Country:US
Practice Address - Phone:480-704-3474
Practice Address - Fax:888-221-2541
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily