Provider Demographics
NPI:1831283019
Name:WHITSELL, MELINDA JO (NMD, NP-C)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:JO
Last Name:WHITSELL
Suffix:
Gender:F
Credentials:NMD, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2058 SOUTH DOBSON ROAD # 11
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202
Mailing Address - Country:US
Mailing Address - Phone:480-831-7970
Mailing Address - Fax:480-831-7971
Practice Address - Street 1:2058 SOUTH DOBSON ROAD # 11
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202
Practice Address - Country:US
Practice Address - Phone:480-831-7970
Practice Address - Fax:480-831-7971
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ03-738175F00000X
AZAP2509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered175F00000XOther Service ProvidersNaturopath
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily