Basic Information
| Provider Information | |||||||||
| NPI: | 1629340195 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECHTOL | ||||||||
| FirstName: | MELINDA | ||||||||
| MiddleName: | JILL | ||||||||
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| Credential: | R.N | ||||||||
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| Mailing Information | |||||||||
| Address1: | PHOENIX INDIAN MEDICAL CTR | ||||||||
| Address2: | P.O BOX 31001-0698 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911100698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022631200 | ||||||||
| FaxNumber: | 6022005383 | ||||||||
| Practice Location | |||||||||
| Address1: | 4212 NORTH 16TH STREET | ||||||||
| Address2: | PHOENIX INDIAN MEDICAL CENTER | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850165319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022361200 | ||||||||
| FaxNumber: | 6022005383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2012 | ||||||||
| LastUpdateDate: | 01/13/2016 | ||||||||
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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 | 163WX0003X | RN190654 | AZ | Y | Nursing Service Providers | Registered Nurse | Obstetric, Inpatient |
No ID Information.