Healthcare Provider Details

I. General information

NPI: 1801062997
Provider Name (Legal Business Name): MELINDA JOYCE BEAN MS CCCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 E ROOSEVELT BLVD
MONROE NC
28112-4017
US

IV. Provider business mailing address

6035 FAIRVIEW RD
CHARLOTTE NC
28210-3256
US

V. Phone/Fax

Practice location:
  • Phone: 704-295-3725
  • Fax: 704-295-3737
Mailing address:
  • Phone: 704-295-3000
  • Fax: 704-295-3468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAY1815
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number10168
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number11640
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: