Provider Demographics
NPI:1235251471
Name:LORD, MELANIE (NP)
Entity Type:Individual
Prefix:MISS
First Name:MELANIE
Middle Name:
Last Name:LORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 NASHVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-1004
Mailing Address - Country:US
Mailing Address - Phone:931-388-8965
Mailing Address - Fax:
Practice Address - Street 1:1600 NASHVILLE HWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-1004
Practice Address - Country:US
Practice Address - Phone:931-388-8965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011751363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner