Provider Demographics
NPI:1336923499
Name:WEBRE, MELISSA MARIE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:WEBRE
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 1:153 TULIP DR
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-7373
Mailing Address - Country:US
Mailing Address - Phone:985-688-3973
Mailing Address - Fax:
Practice Address - Street 1:154 W 25TH ST
Practice Address - Street 2:
Practice Address - City:LAROSE
Practice Address - State:LA
Practice Address - Zip Code:70373-2523
Practice Address - Country:US
Practice Address - Phone:985-693-7597
Practice Address - Fax:985-693-8141
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA250075164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse