MEDICARE: MELLE NATALIE JEUDY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant		GA

General Provider Information

NPI Number	:	1124959861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELLE NATALIE JEUDY

Provider Business Mailing Address
First Line	:	215 COLBURY ST
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-7094
Country	:	US
Telephone Number	:	678-360-0252
Fax Number	:

Provider Business Practice Location Address
First Line	:	8677 HOSPITAL DR
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30134-2277
Country	:	US
Telephone Number	:	404-843-3323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	06/02/2026

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Directions to “ MELLE NATALIE JEUDY ” Practice Location

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