Melancon, Bryan Keith

Melancon, Bryan Keith is an individual health care provider with primary practice located at 8585 Picardy Ave , Baton Rouge LA 70809. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Melancon, Bryan Keith can be contacted via phone (225) 763-4764.

Contact Information

Primary practice address
8585 Picardy Ave Baton Rouge LA 70809
Phone: (225) 763-4764
Fax: (225) 763-4549
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 87222-4549 Louisiana

Profile Details

NPI number 1922005206
LBN Legal business name Melancon, Bryan Keith
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Jun 19th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922005206 NPPES
Louisiana MEDICAID 1470872

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