MEDICARE: MELISSA DRAUGHN MITCHELL

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	163W00000X	Registered Nurse	225089	NC
2	363LF0000X	Family Nurse Practitioner	5011489	NC

General Provider Information

NPI Number	:	1588132070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA DRAUGHN MITCHELL

Provider Business Mailing Address
First Line	:	909 RIDGEBROOK RD STE 300
Second Line	:
City	:	SPARKS
State	:	MD
Zip	:	21152-9477
Country	:	US
Telephone Number	:	443-383-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	6047 TYVOLA GLEN CIR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-6431
Country	:	US
Telephone Number	:	443-383-9300
Fax Number	:

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

Provider Enumeration Date	:	11/02/2018
Last Update Date	:	01/17/2026

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