Provider Demographics
NPI:1780485581
Name:LEBLANC, MELISSA LYNN (RN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:LEBLANC
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LYNN
Other - Last Name:RICHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1747 HANCOCK ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-1130
Mailing Address - Country:US
Mailing Address - Phone:619-772-0252
Mailing Address - Fax:
Practice Address - Street 1:1747 HANCOCK ST STE C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-1130
Practice Address - Country:US
Practice Address - Phone:619-772-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95164980163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy