Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 07577R | LA |
NPI | 1073546149 |
---|---|
Provider Name | Melanie Jeanne Mcknight |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Baton Rouge, LA 70808-4370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 01/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1073546149 | NPI (01) | LA |
1956643 | (05) | LA |
E87724 | (02) |