Provider Demographics
NPI:1689262636
Name:MAYSONET, MELINDA
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:
Last Name:MAYSONET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8991 W FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-0419
Mailing Address - Country:US
Mailing Address - Phone:702-586-5001
Mailing Address - Fax:702-664-0508
Practice Address - Street 1:8991 W FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-0419
Practice Address - Country:US
Practice Address - Phone:702-586-5001
Practice Address - Fax:702-664-0508
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker