Provider Demographics
NPI:1396295051
Name:LIN, MELODY (WHNP)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7424 GREENVILLE AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4534
Mailing Address - Country:US
Mailing Address - Phone:214-363-2004
Mailing Address - Fax:
Practice Address - Street 1:7424 GREENVILLE AVE STE 206
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4534
Practice Address - Country:US
Practice Address - Phone:214-363-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132039363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health