Provider Demographics
NPI:1649523325
Name:ALVARADO, MELANIE SARAH (MSN, ANP-BC, GNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:SARAH
Last Name:ALVARADO
Suffix:
Gender:F
Credentials:MSN, ANP-BC, GNP-BC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:SARAH
Other - Last Name:TAUSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:717 W LAMPASAS ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-4533
Mailing Address - Country:US
Mailing Address - Phone:972-875-6790
Mailing Address - Fax:
Practice Address - Street 1:717 W LAMPASAS ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4533
Practice Address - Country:US
Practice Address - Phone:972-875-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX754657363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health