Provider Demographics
NPI:1467429100
Name:CALABRESE, MELANIE K (PA-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:K
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 S EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-5920
Mailing Address - Country:US
Mailing Address - Phone:480-783-7000
Mailing Address - Fax:
Practice Address - Street 1:13838 S 46TH PL STE 125
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-7802
Practice Address - Country:US
Practice Address - Phone:480-783-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2408363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant