Provider Demographics
NPI:1144846874
Name:VASQUEZ, MELISSA ALEJANDRA (FNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ALEJANDRA
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 UPTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7559
Mailing Address - Country:US
Mailing Address - Phone:956-982-0909
Mailing Address - Fax:
Practice Address - Street 1:120 UPTOWN AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7559
Practice Address - Country:US
Practice Address - Phone:956-982-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily