Provider Demographics
NPI:1871093880
Name:HANSARD, MELANIE S (LVN)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:S
Last Name:HANSARD
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CLAY STREET
Mailing Address - Street 2:
Mailing Address - City:NOCONA
Mailing Address - State:TX
Mailing Address - Zip Code:76255-6419
Mailing Address - Country:US
Mailing Address - Phone:940-531-0569
Mailing Address - Fax:
Practice Address - Street 1:16683 FM 1816
Practice Address - Street 2:
Practice Address - City:NOCONA
Practice Address - State:TX
Practice Address - Zip Code:76255-6419
Practice Address - Country:US
Practice Address - Phone:940-531-0569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX149744164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse