Provider Demographics
NPI:1982051389
Name:LYAPUSTINA, MELISSA ELIANA (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ELIANA
Last Name:LYAPUSTINA
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ELIANA
Other - Last Name:JORQUERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3571 E CALLE PUERTA DE ACERO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2202 W ANKLAM RD STE A263
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85709-3506
Practice Address - Country:US
Practice Address - Phone:520-206-3489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10259363LF0000X
WAAP60657295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ335988Medicaid
AZAP10259OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS