Provider Demographics
NPI:1821382227
Name:GAONA, JESSELYN R
Entity Type:Individual
Prefix:
First Name:JESSELYN
Middle Name:R
Last Name:GAONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSELYN
Other - Middle Name:
Other - Last Name:MELCHER-POST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1300 N 12TH ST STE 605
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2850
Mailing Address - Country:US
Mailing Address - Phone:602-839-4567
Mailing Address - Fax:602-839-2067
Practice Address - Street 1:1300 N 12TH ST STE 605
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2850
Practice Address - Country:US
Practice Address - Phone:602-839-4567
Practice Address - Fax:602-839-2067
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR72650207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine