Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | E7510 | AR |
N | 208600000X | Surgeon | E7510 | AR |
N | 208200000X | Surgeon | TRN9979 | FL |
N | 208600000X | Surgeon | TRN9979 | FL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | E-7510 | AR |
NPI | 1033318589 |
---|---|
Provider Name | Melanie Denise Prince |
First Address | Little Rock, AR 72227-2453 |
Second Address | Little Rock, AR 72227-2453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2007 |
Last Update Date | 29/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
195170001 | (05) | AR |