Provider Demographics
NPI:1427365493
Name:PREJEAN, MELISSA TOTTEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:TOTTEN
Last Name:PREJEAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8299 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-2387
Mailing Address - Country:US
Mailing Address - Phone:337-892-4750
Mailing Address - Fax:
Practice Address - Street 1:2619 CHARITY ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4024
Practice Address - Country:US
Practice Address - Phone:337-385-1250
Practice Address - Fax:337-385-1247
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist