Provider Demographics
NPI:1780020024
Name:LENNON, MELANIE (CPM, LM, ASM, CD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:LENNON
Suffix:
Gender:F
Credentials:CPM, LM, ASM, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 ROAD 11
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-9131
Mailing Address - Country:US
Mailing Address - Phone:307-202-2386
Mailing Address - Fax:
Practice Address - Street 1:751 ROAD 11
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-9131
Practice Address - Country:US
Practice Address - Phone:307-202-2386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY10176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife