Provider Demographics
NPI:1972587244
Name:HANDS, MARY MELISSA
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MELISSA
Last Name:HANDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MELISSA
Other - Last Name:ZAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3202 E. GREENWAY RD.
Mailing Address - Street 2:SUITE 1619
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032
Mailing Address - Country:US
Mailing Address - Phone:602-482-2282
Mailing Address - Fax:602-482-2909
Practice Address - Street 1:3202 E. GREENWAY RD.
Practice Address - Street 2:SUITE 1619
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:602-482-2282
Practice Address - Fax:602-482-2909
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily