Provider Demographics
NPI:1720688369
Name:ARIAS, MELINDA MARIE (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:MARIE
Last Name:ARIAS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MRS
Other - First Name:MELINDA
Other - Middle Name:MARIE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:839 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2819
Mailing Address - Country:US
Mailing Address - Phone:520-792-9890
Mailing Address - Fax:520-884-9287
Practice Address - Street 1:839 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2819
Practice Address - Country:US
Practice Address - Phone:520-792-9890
Practice Address - Fax:520-884-9287
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN148487163W00000X
AZ276769363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse