Organization
DIVINITY HEALTHCARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN MELANCON FNP (FAMILY NURSE PRACTITIONER)
(225) 301-2982
Entity
Organization
Contact information
Practice address
4021 WE HECK CT STE B1, BATON ROUGE, LA 70816-0405
(225) 256-7945
(225) 351-8910
Mailing address
11515 DENHAM RD, GONZALES, LA 70737-7787
(225) 301-2982
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/31/2020
Last updated
05/05/2020
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