Healthcare Provider Details

I. General information

NPI: 1124892153
Provider Name (Legal Business Name): MELISSA CHARLES WOODS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA CHARLES HILL

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 FIELDS DR
SANFORD NC
27330-5066
US

IV. Provider business mailing address

110 FIELDS DR
SANFORD NC
27330-5066
US

V. Phone/Fax

Practice location:
  • Phone: 919-777-9005
  • Fax:
Mailing address:
  • Phone: 919-777-9005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019629
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: