Provider Demographics
NPI:1790143634
Name:MELENDEZ-NAZARIO, GLENDALY (BSN)
Entity Type:Individual
Prefix:MRS
First Name:GLENDALY
Middle Name:
Last Name:MELENDEZ-NAZARIO
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5129 CALLE RENIFORME
Mailing Address - Street 2:JARDINDES DEL CARIBE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-3522
Mailing Address - Country:US
Mailing Address - Phone:787-840-2575
Mailing Address - Fax:
Practice Address - Street 1:5129 CALLE RENIFORME
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-3522
Practice Address - Country:US
Practice Address - Phone:787-840-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-06
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR76627G163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR76627GOtherSTATE LICENSE