Provider Demographics
NPI:1265774921
Name:MELONE, AMANDA LAUREN (MD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LAUREN
Last Name:MELONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LAUREN
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10580 N MCCARRAN BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1896
Mailing Address - Country:US
Mailing Address - Phone:775-447-3097
Mailing Address - Fax:775-432-1264
Practice Address - Street 1:2900 SANDESTIN DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-2137
Practice Address - Country:US
Practice Address - Phone:775-447-3097
Practice Address - Fax:775-432-1264
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV170192084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry