Provider Demographics
NPI:1932969177
Name:MARTINEZ, MELODY LYNN (PMHNP-BC, MSN-APRN)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:LYNN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PMHNP-BC, MSN-APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S MILL AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2899
Mailing Address - Country:US
Mailing Address - Phone:623-267-6601
Mailing Address - Fax:
Practice Address - Street 1:222 S MILL AVE STE 800
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2899
Practice Address - Country:US
Practice Address - Phone:623-267-6601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ264146363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health