Provider Demographics
NPI:1235446899
Name:LOYD, MELANIE DAWN (PA-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:DAWN
Last Name:LOYD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1898 BUFORD BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4442
Mailing Address - Country:US
Mailing Address - Phone:850-877-4113
Mailing Address - Fax:
Practice Address - Street 1:1898 BUFORD BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4442
Practice Address - Country:US
Practice Address - Phone:850-877-4113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2502363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical