Healthcare Provider Details

I. General information

NPI: 1710399217
Provider Name (Legal Business Name): MELANIE WHEELER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

688 WALNUT ST SUITE 200
MACON GA
31201-2677
US

IV. Provider business mailing address

688 WALNUT ST SUITE 200
MACON GA
31201-2677
US

V. Phone/Fax

Practice location:
  • Phone: 478-742-7566
  • Fax: 478-743-2804
Mailing address:
  • Phone: 478-742-7566
  • Fax: 478-743-2804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN0077840
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: