Individual
MELISSA ANN HALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-3614
Mailing address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-3614
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1068494
TX
363LF0000X
Family Nurse Practitioner
Primary
R0092696
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200682930A
—
OK
Enumeration date
11/16/2016
Last updated
02/26/2025
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