Provider Demographics
NPI:1013536366
Name:RAJANAYAGAM, MELAINE ROUSHINI (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MELAINE
Middle Name:ROUSHINI
Last Name:RAJANAYAGAM
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MELAIN
Other - Middle Name:ROUSHINI
Other - Last Name:HITCHCOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS
Mailing Address - Street 1:7714 SAN GABRIEL ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1493
Mailing Address - Country:US
Mailing Address - Phone:919-782-5414
Mailing Address - Fax:
Practice Address - Street 1:3400 WAKE FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7317
Practice Address - Country:US
Practice Address - Phone:919-954-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily