Healthcare Provider Details

I. General information

NPI: 1356817407
Provider Name (Legal Business Name): MELANIE LOREN LAWRENCE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELANIE LOREN VANCE RN, BSN

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E ROWAN AVE STE 150
SPOKANE WA
99207-2244
US

IV. Provider business mailing address

220 E ROWAN AVE STE 150
SPOKANE WA
99207-2244
US

V. Phone/Fax

Practice location:
  • Phone: 509-483-4060
  • Fax: 509-483-0043
Mailing address:
  • Phone: 509-483-4060
  • Fax: 509-483-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61521526
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN60706651
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: