Provider Demographics
NPI:1780987925
Name:DEAN, MELANIE DAWN
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:DAWN
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6759 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-2002
Mailing Address - Country:US
Mailing Address - Phone:702-467-1377
Mailing Address - Fax:702-586-0665
Practice Address - Street 1:5825 MARY WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-4776
Practice Address - Country:US
Practice Address - Phone:702-684-0129
Practice Address - Fax:702-586-0665
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care