Logue, Melanie Dane

Logue, Melanie Dane is an individual health care provider with primary practice located at 1000 Vale Terrace Dr , Vista CA 92084. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Logue, Melanie Dane can be contacted via phone (308) 500-3844.

Contact Information

Primary practice address
1000 Vale Terrace Dr Vista CA 92084
Phone: (308) 500-3844
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN083247 Arizona
Nursing Service Providers / Registered Nurse 163W00000X RN95148897 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP95008920 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NPF95008920 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP0835 Arizona

Profile Details

NPI number 1336121094
LBN Legal business name Logue, Melanie Dane
Credentials PHD, DNP, APRN, CFNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Mar 20th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336121094 NPPES
Arizona MEDICAID 490699

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