Provider Demographics
NPI:1891712501
Name:MCNABB, MARI MELISSA (APRN-BC FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARI
Middle Name:MELISSA
Last Name:MCNABB
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Gender:F
Credentials:APRN-BC FNP
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Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-765-5500
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:312 GRAMMONT ST STE 404
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7403
Practice Address - Country:US
Practice Address - Phone:318-966-2001
Practice Address - Fax:318-966-2007
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-01-06
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Provider Licenses
StateLicense IDTaxonomies
LAAP04116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1141836Medicaid
LA4C378C599Medicare UPIN
LA1141836Medicaid