MEDICARE: MELANIE K STONE FNP C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SC2300X	Chronic Care Clinical Nurse Specialist	APN0000010841	TN
2	363LP2300X	Primary Care Nurse Practitioner	10841	TN
3	363L00000X	Nurse Practitioner	1-040815	AL

General Provider Information

NPI Number	:	1467413922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE K STONE FNP C

Provider Business Mailing Address
First Line	:	726 NORTH LOCUST AVE
Second Line	:	FIRST FLOOR SUITE D
City	:	LAWRENCEBURG
State	:	TN
Zip	:	38464-2762
Country	:	US
Telephone Number	:	931-766-7056
Fax Number	:	931-766-7057

Provider Business Practice Location Address
First Line	:	726 NORTH LOCUST AVENUE
Second Line	:	1ST FLOOR SUITE D
City	:	LAWRENCEBURG
State	:	TN
Zip	:	38464-2762
Country	:	US
Telephone Number	:	931-766-7056
Fax Number	:	931-766-7057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	06/12/2024

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