Individual
JACKIE S MELANCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36000 DARNALL LOOP, FORT HOOD, TX 76544-5095
(254) 286-7702
Mailing address
36000 DARNALL LOOP, FORT HOOD, TX 76544-5095
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
198906
TX
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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