Individual
BRIAN MARK MELANCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-C
Contact information
Practice address
6 COLLEGE ST, DUE WEST, SC 29639-9554
(864) 379-2345
Mailing address
313 PROJECT RD, IVA, SC 29655-9055
(864) 616-1062
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25065
SC
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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