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Individual

STORIE MELANCON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
6330 MOURNING DOVE DR, BATON ROUGE, LA 70817-1155
(225) 761-8687
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0011
(225) 765-9196

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AP09381
LA
363LF0000X
Family Nurse Practitioner
AP09381
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006264148
DRIVER'S LICENSE
LA
01
AP09381
APRN LICENSE
LA
01
RN132519
RN LICENSE
LA
Enumeration date
07/12/2017
Last updated
06/05/2025
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