Provider Demographics
NPI:1639192867
Name:CONNOR, MELANIE FLETCHER (RN FA)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:FLETCHER
Last Name:CONNOR
Suffix:
Gender:F
Credentials:RN FA
Other - Prefix:
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Mailing Address - Street 1:1 SAINT MARY PL
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4343
Mailing Address - Country:US
Mailing Address - Phone:318-681-4160
Mailing Address - Fax:318-681-6314
Practice Address - Street 1:1 SAINT MARY PL
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4343
Practice Address - Country:US
Practice Address - Phone:318-681-4160
Practice Address - Fax:318-681-6314
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LARN103936163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse