Provider Demographics
NPI:1962803973
Name:JANAK, MELANIE (MS, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:JANAK
Suffix:
Gender:F
Credentials:MS, APRN, FNP-C
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9706 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-3811
Mailing Address - Country:US
Mailing Address - Phone:361-550-7578
Mailing Address - Fax:
Practice Address - Street 1:2900 E 29TH ST
Practice Address - Street 2:STE 200
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2622
Practice Address - Country:US
Practice Address - Phone:979-776-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily