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General NPI Number Information
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NPI Number | 1518349950
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Entity Type | Individual
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Provider Name | MELINDA BALDUCCI UPSHUR FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 07/07/2024
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Provider Practice Location Address
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Address Line | 111 HIGHWAY 82 E STE B
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City | LELAND
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State | MS
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Zip | 38756-3421
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Country | US
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Telephone | 662-820-0079
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Fax | 662-200-5896
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Provider Business Mailing Address
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Address Line | 111 HIGHWAY 82 E STE B
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City | LELAND
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State | MS
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Zip | 38756-3421
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Country | US
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Telephone | 662-820-0079
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Fax | 662-200-5896
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A004430
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 865804
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License Number State | MS
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