Provider Demographics
NPI:1588796536
Name:HODNIK, MELINDA LOU (RNFA)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:LOU
Last Name:HODNIK
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:LOU
Other - Last Name:MARBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3200 VILLA PL
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-3354
Mailing Address - Country:US
Mailing Address - Phone:806-353-3529
Mailing Address - Fax:806-355-5104
Practice Address - Street 1:8 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4168
Practice Address - Country:US
Practice Address - Phone:806-353-3529
Practice Address - Fax:806-355-5104
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX239823163W00000X, 163WR0006X, 163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Not Answered163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC19165Medicare UPIN
TX00M163Medicare ID - Type UnspecifiedR.F. MCKAY, M. D. EMPLOYE