Provider Demographics
NPI:1760886634
Name:LOZANO, MELANIE VALMONTE (PA)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:VALMONTE
Last Name:LOZANO
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1580 W ANTELOPE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1160
Mailing Address - Country:US
Mailing Address - Phone:801-773-4770
Mailing Address - Fax:801-773-4776
Practice Address - Street 1:1580 W ANTELOPE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1160
Practice Address - Country:US
Practice Address - Phone:801-773-4770
Practice Address - Fax:801-773-4776
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2015-05-08
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Provider Licenses
StateLicense IDTaxonomies
UT6984101-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant