MEDICARE: MELISSA PERERA LEBRUN FNP-C

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	363LF0000X	Family Nurse Practitioner	AP06496	LA
2	363LF0000X	Family Nurse Practitioner	AP139987	TX

General Provider Information

NPI Number	:	1922386879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA PERERA LEBRUN FNP-C

Provider Business Mailing Address
First Line	:	17052 HUNTERS TRCE E
Second Line	:
City	:	PRAIRIEVILLE
State	:	LA
Zip	:	70769-4839
Country	:	US
Telephone Number	:	225-939-0050
Fax Number	:

Provider Business Practice Location Address
First Line	:	9722 GREAT HILLS TRL STE 375
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7263
Country	:	US
Telephone Number	:	512-910-3932
Fax Number	:	888-972-1912

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

Provider Enumeration Date	:	07/26/2011
Last Update Date	:	05/16/2024

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