Provider Demographics
NPI:1477840569
Name:NELSON, MELINDA (PHD, CNP)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHD, CNP
Other - Prefix:DR
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:MCCUSKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1901 MEDI PARK DR STE 2058
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2109
Mailing Address - Country:US
Mailing Address - Phone:501-201-0190
Mailing Address - Fax:
Practice Address - Street 1:1901 MEDI PARK DR STE 2058
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2109
Practice Address - Country:US
Practice Address - Phone:866-959-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0000281-C-NP363LP0808X
TXAP120518363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health