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NPI Code Detail

MEDICARE: DENISE MELANCON DNP

MEDICARE: DENISE MELANCON DNP
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
1363LF0000XFamily Nurse PractitionerAP08946LA

General Provider Information

NPI Number : 1861845695
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE MELANCON DNP
Provider Business Mailing Address
First Line : 3656 FRANKLIN AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70122-5947
Country : US
Telephone Number : 504-905-5444
Fax Number : 504-373-6444
Provider Business Practice Location Address
First Line : 4710 S CARROLLTON AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-6027
Country : US
Telephone Number : 504-454-9020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2016
Last Update Date : 09/02/2016

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