Provider Demographics
NPI:1275086126
Name:LENTZ, MELANIE (FNPBC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:LENTZ
Suffix:
Gender:F
Credentials:FNPBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 E CALVADA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-3906
Mailing Address - Country:US
Mailing Address - Phone:775-210-8333
Mailing Address - Fax:775-346-9158
Practice Address - Street 1:1470 E CALVADA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-3906
Practice Address - Country:US
Practice Address - Phone:775-210-8333
Practice Address - Fax:775-346-9158
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN64130163WG0000X
NVAPRN002359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice