Provider Demographics
NPI:1154798775
Name:HOWARD, MELANIE (APRN)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 GOVERNOR ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:GA
Mailing Address - Zip Code:31408-2301
Mailing Address - Country:US
Mailing Address - Phone:912-349-6728
Mailing Address - Fax:
Practice Address - Street 1:2613 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:GA
Practice Address - Zip Code:31408-2301
Practice Address - Country:US
Practice Address - Phone:912-349-6728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN140328363LF0000X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist