1255751699 NPI number — MS. JOYCE PATTERSON MELTON R.N.

Table of content: MS. JOYCE PATTERSON MELTON R.N. (NPI 1255751699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255751699 NPI number — MS. JOYCE PATTERSON MELTON R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MELTON
Provider First Name:
JOYCE
Provider Middle Name:
PATTERSON
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LOVE(JOYCE ELAINE PATTERSON(MAIDEN)
Provider Other First Name:
JOYCE
Provider Other Middle Name:
PATTERSON
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.N.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1255751699
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 34452
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-391-7476
Provider Business Mailing Address Fax Number:
704-391-7476

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7409 PAWTUCKETT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-391-7476
Provider Business Practice Location Address Fax Number:
704-391-7476
Provider Enumeration Date:
04/24/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  051151 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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