Provider Demographics
NPI:1689154965
Name:LAUGHLIN, MELANIE (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 N PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-3864
Mailing Address - Country:US
Mailing Address - Phone:405-517-9280
Mailing Address - Fax:
Practice Address - Street 1:1800 E COPLIN ST
Practice Address - Street 2:
Practice Address - City:OKEMAH
Practice Address - State:OK
Practice Address - Zip Code:74859-4642
Practice Address - Country:US
Practice Address - Phone:405-943-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK105464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily