Healthcare Provider Details

I. General information

NPI: 1235064916
Provider Name (Legal Business Name): NIC MELO L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NICOLE MELO

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 CLAYTON ST
ASHEVILLE NC
28801-2424
US

IV. Provider business mailing address

16 SKYLAND CIR
WOODFIN NC
28804-2027
US

V. Phone/Fax

Practice location:
  • Phone: 504-342-1772
  • Fax:
Mailing address:
  • Phone: 504-342-1772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2035
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: