Melissa Michelle Bordelon, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

694305 Issued in TX

Practice address

820 Nantucket Dr
Beaumont, TX 77706-5335

Phone

(409) 673-9684

NPI assigned

Aug 10, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1972286409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 NANTUCKET DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777065335",
            "telephone_number": "409-673-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 NANTUCKET DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777065335",
            "telephone_number": "409-673-9684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "MELISSA",
        "middle_name": "MICHELLE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "694305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magan Fontenot Bonner, LPC ASSOCIATE
• Madison Bonvillion, FNP-C
• Nancy Gail Boone, FNP
• John Walter Bordages Jr., PH.D.
• Sara Bordages, M.S. CCC-SLP
• Kinli Marie Borque
• Phillip Alan Bostwick, DDS
• Tierney Botley, NP
• Amber Kay Boudreaux, LMT
• Paula Boudreaux, CFY SLP

• All providers in Beaumont, TX
• Lactation Consultant (Registered Nurse) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.