Provider Demographics
NPI:1457634289
Name:VERNER, MELODY R (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:R
Last Name:VERNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:
Other - Last Name:REDDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4330 MEDICAL DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3342
Mailing Address - Country:US
Mailing Address - Phone:210-576-5306
Mailing Address - Fax:210-694-0645
Practice Address - Street 1:4330 MEDICAL DR
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3342
Practice Address - Country:US
Practice Address - Phone:210-576-5306
Practice Address - Fax:210-694-0645
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX717854363LF0000X
TXAP120910363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
312878YMVUMedicare PIN