Healthcare Provider Details

I. General information

NPI: 1669302998
Provider Name (Legal Business Name): CYNTHIA DEBNAM MELVIN AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12107 NC HIGHWAY 96 N
ZEBULON NC
27597-7428
US

IV. Provider business mailing address

12107 NC HIGHWAY 96 N
ZEBULON NC
27597-7428
US

V. Phone/Fax

Practice location:
  • Phone: 336-681-7342
  • Fax:
Mailing address:
  • Phone: 336-681-7342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAG05260041
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: