Provider Demographics
NPI:1548678469
Name:MELANCON, DAWN (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:MELANCON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:LASHA
Other - Last Name:BRADFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:4021 WE HECK CT
Mailing Address - Street 2:STE B1
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-0405
Mailing Address - Country:US
Mailing Address - Phone:225-256-7945
Mailing Address - Fax:225-450-1736
Practice Address - Street 1:14360 WAX RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818-4279
Practice Address - Country:US
Practice Address - Phone:225-261-6541
Practice Address - Fax:225-262-0502
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07980363L00000X, 363LX0106X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health