Doctor Name: | MRS. MELVANIE MELTON-SMITH |
NPI Number: | 1104293927 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | RN155243 |
Business Practice Address: | 201 W Pine St Fitzgerald, GA - 317502863 |
Business Phone Number: | 2294234384 |
Business Fax Number: | 2294234387 |
Mailing Address: | Po Box 1447, FITZGERALD |
State: | GA |
Postal Code: | 317501447 |
Phone Number: | 2294234384 |
Fax Number: | 2294234387 |
NPI Enumeration Date: | 08/27/2015 |
NPI Last Update Date: | 08/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN155243 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |