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General NPI Number Information
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NPI Number | 1033628581
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Entity Type | Individual
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Provider Name | MELISSA REBECCA POWIDZKI PA-C, CAQ-PSYCH
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Gender | Female
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 2579 CHIMNEY ROCK RD
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City | HENDERSONVILLE
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State | NC
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Zip | 28792-9181
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Country | US
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Telephone | 828-692-4289
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Fax | 828-696-1794
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Provider Business Mailing Address
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Address Line | 220 5TH AVE E
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City | HENDERSONVILLE
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State | NC
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Zip | 28792-4377
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Country | US
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Telephone | 828-692-4289
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Fax | 828-696-1794
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 7553
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-11130
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License Number State | NC
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