Basic Information
| Provider Information | |||||||||
| NPI: | 1790096238 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARDENAS | ||||||||
| FirstName: | MELISSA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10476 HUMBOLDT ST | ||||||||
| Address2: | |||||||||
| City: | NORTHGLENN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802334246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037045184 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2400 S PEORIA ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800145417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033064321 | ||||||||
| FaxNumber: | 3033064350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2010 | ||||||||
| LastUpdateDate: | 06/30/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 111488 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.