Provider Demographics
NPI:1770667701
Name:WEST, MELANY ANN (NP)
Entity Type:Individual
Prefix:
First Name:MELANY
Middle Name:ANN
Last Name:WEST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MELANY
Other - Middle Name:A
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:2003 C C BEL RD
Mailing Address - Street 2:
Mailing Address - City:ELTON
Mailing Address - State:LA
Mailing Address - Zip Code:70532-5318
Mailing Address - Country:US
Mailing Address - Phone:337-584-1439
Mailing Address - Fax:337-584-1501
Practice Address - Street 1:216 PARK ST
Practice Address - Street 2:
Practice Address - City:KROTZ SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70750
Practice Address - Country:US
Practice Address - Phone:337-566-2762
Practice Address - Fax:337-566-2766
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA020404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1559211Medicaid