Basic Information
| Provider Information | |||||||||
| NPI: | 1740457837 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EVERETT | ||||||||
| FirstName: | MELINDA | ||||||||
| MiddleName: | PAIGE | ||||||||
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| Credential: | WHCNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 CONNER DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275147092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199428571 | ||||||||
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| Practice Location | |||||||||
| Address1: | 120 CONNER DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275147092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199428571 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2008 | ||||||||
| LastUpdateDate: | 05/09/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 940070 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 940070 | 01 | NC | NC LICENSE | OTHER |