Healthcare Provider Details

I. General information

NPI: 1437209020
Provider Name (Legal Business Name): MELINDA 0'BRIANT MCLAIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 HILLSBOROUGH ST CARROLL HEALTH CENTER
RALEIGH NC
27607-5237
US

IV. Provider business mailing address

3800 HILLSBOROUGH ST CARROLL HEALTH CENTER
RALEIGH NC
27607-5237
US

V. Phone/Fax

Practice location:
  • Phone: 919-760-8535
  • Fax:
Mailing address:
  • Phone: 919-760-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberCONFIDENTIAL INFO
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: