Provider Demographics
NPI:1831407485
Name:MARANTO, MELINDA S (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:S
Last Name:MARANTO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 HWY 641 NORTH, SUITE D
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38320-1393
Mailing Address - Country:US
Mailing Address - Phone:731-213-2271
Mailing Address - Fax:731-213-2276
Practice Address - Street 1:727 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-1924
Practice Address - Country:US
Practice Address - Phone:615-673-6737
Practice Address - Fax:800-474-4039
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15700363LF0000X
TNF0910038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily