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General NPI Number Information
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NPI Number | 1952086746
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Entity Type | Individual
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Provider Name | ROSEMARY JANE MELENDEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1000 MEDICAL CENTER BLVD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7694
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Country | US
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Telephone | 678-312-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 397 WINFORD SMITH RD
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City | ATHENS
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State | GA
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Zip | 30607-3963
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Country | US
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Telephone | 706-201-6312
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA064770
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License Number State | PA
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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 | 12881
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License Number State | GA
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