Basic Information
| Provider Information | |||||||||
| NPI: | 1275086126 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LENTZ | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | FNPBC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1470 E CALVADA BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | PAHRUMP | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890483906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752108333 | ||||||||
| FaxNumber: | 7753469158 | ||||||||
| Practice Location | |||||||||
| Address1: | 1470 E CALVADA BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | PAHRUMP | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890483906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752108333 | ||||||||
| FaxNumber: | 7753469158 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2016 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | RN64130 | NV | N | Nursing Service Providers | Registered Nurse | General Practice | 363LF0000X | APRN002359 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.