Individual
MRS. MELONEY DIANE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7741 LITTLEROCK RD. SW, TUMWATER, WA 98512
(360) 709-7896
(360) 709-7802
Mailing address
7741 LITTLEROCK RD. SW, TUMWATER, WA 98512
(360) 709-7896
(360) 709-7802
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60845980
WA
164X00000X
Licensed Vocational Nurse
VN253289
CA
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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