Basic Information
| Provider Information | |||||||||
| NPI: | 1972578433 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | C.P.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 195 W ILLINOIS AVE | ||||||||
| Address2: | |||||||||
| City: | SOUTHERN PINES | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283875808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106922444 | ||||||||
| FaxNumber: | 9106923651 | ||||||||
| Practice Location | |||||||||
| Address1: | 195 W ILLINOIS AVE | ||||||||
| Address2: | |||||||||
| City: | SOUTHERN PINES | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283875808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106922444 | ||||||||
| FaxNumber: | 9106923651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 66826 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 134624 | 01 | NC | NURSE LICENSE | OTHER |