| Melanie G Petchak, NP-BC | |
|
7611 Saint Vincent Ave, Shreveport, LA 71106-4231 | |
| (318) 861-1671 | |
| Not Available |
| Full Name | Melanie G Petchak |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 7611 Saint Vincent Ave, Shreveport, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336363845 | NPI | - | NPPES |
| 1166430 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | APO3820 (Louisiana) | Primary |
| Entity Name | Geriatric Nurse Practitioner Consultants Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932527249 PECOS PAC ID: 6507398294 Enrollment ID: O20241018003081 |
| Mailing Address | Practice Location Address |
|---|---|
| Melanie G Petchak, NP-BC 1 Saint Mary Pl, Shreveport, LA 71101-4343 Ph: (318) 861-1671 | Melanie G Petchak, NP-BC 7611 Saint Vincent Ave, Shreveport, LA 71106-4231 Ph: (318) 861-1671 |
Lasonya Jones, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7840 Jewella Ave, Shreveport, LA 71108 Phone: 318-401-1432 Fax: 318-562-3889 | |
James E Harper, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1500 Line Avenue, Ste 200, Shreveport, LA 71101 Phone: 318-629-5555 Fax: 318-629-5556 | |
Tamara J Trainer, RN, WHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1525 Fairfield Room 551, Dhh-office Of Public Health, Shreveport, LA 71101 Phone: 318-676-7470 | |
Ms. Shannon Renee Gully, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 510 E Stoner Ave, Shreveport, LA 71101 Phone: 318-221-8411 | |
Alana O Bragg, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1501 Kings Hwy, Department Of Ob/gyn, Shreveport, LA 71103 Phone: 318-675-5379 Fax: 318-675-4671 | |
Pamela B. Simmons, PHD, APRN, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 865 Olive St, Shreveport, LA 71104 Phone: 318-470-6194 | |
Barbara Lynn Bruner, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 |