MEDICARE: MS. MELISSA A. LAMA N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	AP06601	LA

General Provider Information

NPI Number	:	1134489032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA A. LAMA N.P.

Provider Business Mailing Address
First Line	:	105 E OAK ST
Second Line	:
City	:	PONCHATOULA
State	:	LA
Zip	:	70454-2619
Country	:	US
Telephone Number	:	985-386-6198
Fax Number	:	985-386-6223

Provider Business Practice Location Address
First Line	:	105 E OAK ST
Second Line	:
City	:	PONCHATOULA
State	:	LA
Zip	:	70454-2619
Country	:	US
Telephone Number	:	985-386-6198
Fax Number	:	985-386-6223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2012
Last Update Date	:	05/24/2012

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