MEDICARE: MELISSA EDWARDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician
2	246RP1900X	Phlebotomy Technician		NC

General Provider Information

NPI Number	:	1508749896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA EDWARDS

Provider Business Mailing Address
First Line	:	2501A BRAGG BLVD # 1007
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-4141
Country	:	US
Telephone Number	:	910-644-0510
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501A BRAGG BLVD # 1007
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-4141
Country	:	US
Telephone Number	:	910-644-0510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2025
Last Update Date	:	07/26/2025

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Directions to “ MELISSA EDWARDS ” Practice Location

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