Healthcare Provider Details

I. General information

NPI: 1609743533
Provider Name (Legal Business Name): AERAN ELIZABETH MELANCON LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 CONSTANTIN BLVD FL 3
BATON ROUGE LA
70809-3481
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-7824
  • Fax: 225-765-1173
Mailing address:
  • Phone: 225-765-8988
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number349634
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: