Individual
DR. MELISSA L LYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2751 ALBERT BICKNELL DRIVE, STE 3C, SHREVEPORT, LA 71103-3943
(318) 000-0000
(318) 000-0000
Mailing address
2751 ALBERT BICKNELL DRIVE, STE 3C, SHREVEPORT, LA 71103-3943
(318) 000-0000
(318) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
020492
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107235703
TEXAS MEDICAID
TX
01
—
130022957
RAILROAD MEDICARE
—
05
—
1967327
—
LA
01
—
720702002LY
OCHSNER
LA
01
—
A011
CHAMPUS
—
Enumeration date
09/20/2005
Last updated
12/26/2014
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