Provider Demographics
NPI:1598246423
Name:SCOTT, MELANIE ANN (LVN)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 JAN ST
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-2478
Mailing Address - Country:US
Mailing Address - Phone:254-747-1779
Mailing Address - Fax:
Practice Address - Street 1:1006 JAN ST
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2478
Practice Address - Country:US
Practice Address - Phone:254-747-1779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213313164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse