Provider Demographics
NPI:1437751914
Name:MALDONADO, MELISSA JOY (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOY
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:MALDONADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6930 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2312
Mailing Address - Country:US
Mailing Address - Phone:956-728-8999
Mailing Address - Fax:956-728-8995
Practice Address - Street 1:6930 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2312
Practice Address - Country:US
Practice Address - Phone:956-728-8999
Practice Address - Fax:956-728-8995
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily