Provider Demographics
NPI:1598994329
Name:MELTON, SUSAN ANNETTE (RNP/)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ANNETTE
Last Name:MELTON
Suffix:
Gender:F
Credentials:RNP/
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:ANNETTE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNP
Mailing Address - Street 1:1 CHALAMONT WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5503
Mailing Address - Country:US
Mailing Address - Phone:501-868-7438
Mailing Address - Fax:
Practice Address - Street 1:1 CHALAMONT WAY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5503
Practice Address - Country:US
Practice Address - Phone:501-868-7438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP01403163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse