Provider Demographics
NPI:1124563390
Name:BRELAND, MELANIE (APRN)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:BRELAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 HOLLY ST # 4984
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-4984
Mailing Address - Country:US
Mailing Address - Phone:803-536-2725
Mailing Address - Fax:803-534-3118
Practice Address - Street 1:940 HOLLY ST # 4984
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-4984
Practice Address - Country:US
Practice Address - Phone:803-536-2725
Practice Address - Fax:803-534-3118
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily