Provider Demographics
NPI:1730424045
Name:LEONARD, MELISSA DIANE (NNP-BC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DIANE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:DIANE
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4200 HOUMA BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2970
Mailing Address - Country:US
Mailing Address - Phone:504-454-4990
Mailing Address - Fax:504-454-4541
Practice Address - Street 1:4200 HOUMA BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2970
Practice Address - Country:US
Practice Address - Phone:504-454-4990
Practice Address - Fax:504-454-4541
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN063746 AP01227363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care