Healthcare Provider Details

I. General information

NPI: 1265861785
Provider Name (Legal Business Name): MELANIE WALDEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELANIE BENSON PA-C

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5324 MCFARLAND RD STE 170
DURHAM NC
27707-6872
US

IV. Provider business mailing address

255 SHERMAN PINES DR
FUQUAY VARINA NC
27526-4129
US

V. Phone/Fax

Practice location:
  • Phone: 984-253-1728
  • Fax:
Mailing address:
  • Phone: 630-669-0429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001008662
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: