Individual
CARLY MICHELLE MELANCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
1801 W KOENIG LN, AUSTIN, TX 78756-1208
(512) 808-0543
Mailing address
1801 W KOENIG LN, AUSTIN, TX 78756-1208
(512) 808-0543
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP142178
TX
Other
Enumeration date
07/10/2019
Last updated
04/04/2024
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