MEDICARE: MELANIE MILLER DURHAM NP

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	AP116202	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8Y2615	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730379611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE MILLER DURHAM NP

Provider Business Mailing Address
First Line	:	621 N HALL ST STE 400
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75226-1316
Country	:	US
Telephone Number	:	469-800-7400
Fax Number	:	469-800-7410

Provider Business Practice Location Address
First Line	:	621 N HALL ST STE 400
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75226-1316
Country	:	US
Telephone Number	:	469-800-7400
Fax Number	:	469-800-7410

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

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	05/05/2023

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