Individual
MELISSA MERICLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3434 JOHNETTE ST, SHREVEPORT, LA 71105-2028
(318) 868-7204
Mailing address
3434 JOHNETTE ST, SHREVEPORT, LA 71105-2028
(318) 868-7204
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
109589
LA
Other
Enumeration date
05/28/2007
Last updated
07/08/2007
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