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General NPI Number Information
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NPI Number | 1144379348
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Entity Type | Individual
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Provider Name | MELANIE A HURSTON P.A.
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 257 WINTON M BLOUNT LOOP
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City | MONTGOMERY
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State | AL
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Zip | 36117-3507
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Country | US
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Telephone | 334-396-1886
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Fax | 336-396-1887
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Provider Business Mailing Address
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Address Line | PO BOX 231509
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City | MONTGOMERY
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State | AL
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Zip | 36123-1509
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Country | US
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Telephone | 334-396-1886
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Fax | 334-396-1887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA.77
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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