Provider Demographics
NPI:1740998392
Name:LANDRUM, MELANIEE
Entity type:Individual
Prefix:MRS
First Name:MELANIEE
Middle Name:
Last Name:LANDRUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39111 6 MILE RD STE 159
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3926
Mailing Address - Country:US
Mailing Address - Phone:734-632-8481
Mailing Address - Fax:
Practice Address - Street 1:39111 6 MILE RD STE 159
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3926
Practice Address - Country:US
Practice Address - Phone:734-632-8481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula