Individual
MRS. MELANIE YVETTE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
401 W 70TH ST, SHREVEPORT, LA 71106-3034
(318) 868-4552
Mailing address
401 W 70TH ST, SHREVEPORT, LA 71106-3034
(318) 868-4552
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
AP226239
LA
363LP0200X
Pediatric Nurse Practitioner
Primary
AP226239
LA
Other
Enumeration date
06/21/2022
Last updated
10/25/2023
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