Healthcare Provider Details

I. General information

NPI: 1477270841
Provider Name (Legal Business Name): MELODY ORDINARIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 W PETTIGREW ST
DURHAM NC
27705-4820
US

IV. Provider business mailing address

114 WRIGHT HILL DR
DURHAM NC
27712-9093
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-7705
  • Fax:
Mailing address:
  • Phone: 919-599-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5017107
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: