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General NPI Number Information
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NPI Number | 1285481960
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Entity Type | Individual
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Provider Name | MELANIE KATRIN RICHARDSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/01/2024
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 1000 SOCIAL ST STE 300
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City | RALEIGH
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State | NC
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Zip | 27609-2102
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Country | US
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Telephone | 980-880-3899
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Fax |
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Provider Business Mailing Address
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Address Line | 907 N GLENWOOD TRL
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-7324
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Country | US
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Telephone | 910-639-4394
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.029175
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5019772
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License Number State | NC
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