Individual
MELANIE D COLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
391 S 1ST ST, JESUP, GA 31545-1132
(912) 427-8433
(912) 427-9851
Mailing address
391 S 1ST ST, JESUP, GA 31545-1132
(912) 427-8433
(912) 427-9851
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN057165
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50BBJZG
MEDICARE PROVIDER NUMBER
GA
Enumeration date
07/06/2006
Last updated
08/15/2008
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