Healthcare Provider Details

I. General information

NPI: 1760300511
Provider Name (Legal Business Name): MELISSA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 WINDY HILL DR STE C
RALEIGH NC
27609-5277
US

IV. Provider business mailing address

4940 WINDY HILL DR STE C
RALEIGH NC
27609-5277
US

V. Phone/Fax

Practice location:
  • Phone: 919-453-3738
  • Fax:
Mailing address:
  • Phone: 919-453-3738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number17618
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: