MEDICARE: MELISSA TISDALE BEINKEMPER APRN, PC-PNP

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	363LP0200X	Pediatric Nurse Practitioner	225868	LA

General Provider Information

NPI Number	:	1699405415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA TISDALE BEINKEMPER APRN, PC-PNP

Provider Business Mailing Address
First Line	:	7373 PERKINS RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4326
Country	:	US
Telephone Number	:	225-246-9301
Fax Number	:	225-246-9160

Provider Business Practice Location Address
First Line	:	920 OLIVER RD
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-5702
Country	:	US
Telephone Number	:	318-807-6263
Fax Number	:	318-812-7348

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

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	05/07/2026

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