Provider Demographics
NPI:1750450649
Name:MELARO, LAURA K (DNP, APN, FNP/FPMHNP)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:K
Last Name:MELARO
Suffix:
Gender:F
Credentials:DNP, APN, FNP/FPMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 W SIXTH ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-1515
Mailing Address - Country:US
Mailing Address - Phone:731-608-3531
Mailing Address - Fax:
Practice Address - Street 1:587 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340-2440
Practice Address - Country:US
Practice Address - Phone:731-608-3531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN6039363LP0808X
TNAPN0000006039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN573577000Medicaid
TN573577000Medicaid