| Doctor Name: | MELISSA CHRISTINE LEBOUTON |
| NPI Number: | 1144471970 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PAC |
| License Number: | 4327 |
| Business Practice Address: | 14418 W Meeker Blvd Suite 110 Sun City West, AZ - 853755283 |
| Business Phone Number: | 6235849500 |
| Business Fax Number: | 6235844945 |
| Mailing Address: | 6771 W Miner Trl, PEORIA |
| State: | AZ |
| Postal Code: | 853833008 |
| Phone Number: | 6237488373 |
| Fax Number: | 6237488373 |
| NPI Enumeration Date: | 10/10/2008 |
| NPI Last Update Date: | 07/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 4327 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |