Melynda Fenn, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

225667 Issued in AZ

Practice address

19805 N 51St Ave Ste 33
Glendale, AZ 85308-5198

Phone

(602) 540-3547

NPI assigned

May 3, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1871158063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19805 N 51ST AVE STE 33",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085198",
            "telephone_number": "602-540-3547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19805 N 51ST AVE STE 33",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085198",
            "telephone_number": "602-540-3547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENN",
        "first_name": "MELYNDA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "225667",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "225667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rene Eduardo Felix
• Feliz Family Care, PLLC
• Jeffrey E. Fellner, D.D.S.
• Lynnea Felton, NMD
• Richard Fendorak, PHARMD
• Meghan Maureen Fenske, PA-C
• Marisa Feore
• Bruce Fergen, FNP
• Melissa Ferguson
• Amanda Michelle Fernandez, MA, BCBA, LBA

• All providers in Glendale, AZ
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.