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General NPI Number Information
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NPI Number | 1679914154
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Entity Type | Individual
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Provider Name | MELISSA B HANISH FNP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 1617 N WASHINGTON
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City | MAGNOLIA
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State | AR
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Zip | 71753-2046
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Country | US
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Telephone | 870-234-7676
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Fax | 570-562-2559
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Provider Business Mailing Address
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Address Line | 1617 N WASHINGTON
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City | MAGNOLIA
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State | AR
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Zip | 71753-2046
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Country | US
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Telephone | 870-234-7676
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Fax |
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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 | AP07438
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License Number State | LA
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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 | 228907
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License Number State | AR
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