Provider Demographics
NPI:1598413049
Name:MELANCON, KAY CHRISTINE (AGACNP)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:CHRISTINE
Last Name:MELANCON
Suffix:
Gender:
Credentials:AGACNP
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:MELANCON
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:337-470-3980
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:4809 AMBASSADOR CAFFERY PKWY STE 490
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8802
Practice Address - Country:US
Practice Address - Phone:337-470-3980
Practice Address - Fax:337-470-3989
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA224418363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care