Provider Demographics
NPI:1992498026
Name:SLOOP, MELANIE RENE' (LDO, ABOC, NCLEC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:RENE'
Last Name:SLOOP
Suffix:
Gender:F
Credentials:LDO, ABOC, NCLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-1814
Mailing Address - Country:US
Mailing Address - Phone:252-462-3017
Mailing Address - Fax:252-459-9906
Practice Address - Street 1:1205 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-1814
Practice Address - Country:US
Practice Address - Phone:252-462-3017
Practice Address - Fax:252-459-9906
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2250156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician