Healthcare Provider Details

I. General information

NPI: 1043292139
Provider Name (Legal Business Name): MELANIE THARP RNC, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MEDICAL CENTER DR SUITE 200
ALEXANDRIA LA
71301-8124
US

IV. Provider business mailing address

6206 ASHFORD DR
ALEXANDRIA LA
71303-2068
US

V. Phone/Fax

Practice location:
  • Phone: 318-487-1289
  • Fax: 318-487-1254
Mailing address:
  • Phone: 318-443-9338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN058633
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: