Provider Demographics
NPI:1457116931
Name:MELERINE, WAYNE JR (LPN)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:
Last Name:MELERINE
Suffix:JR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 CAREY ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3627
Mailing Address - Country:US
Mailing Address - Phone:985-646-6406
Mailing Address - Fax:985-646-6460
Practice Address - Street 1:2331 CAREY ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3627
Practice Address - Country:US
Practice Address - Phone:985-646-6406
Practice Address - Fax:985-646-6460
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA950328164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse