Provider Demographics
NPI:1245567007
Name:PITTS, MELANIE ANN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ANN
Last Name:PITTS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:ANN
Other - Last Name:WICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4005 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-8058
Mailing Address - Country:US
Mailing Address - Phone:910-848-5439
Mailing Address - Fax:910-848-5439
Practice Address - Street 1:4005 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-8058
Practice Address - Country:US
Practice Address - Phone:910-848-5439
Practice Address - Fax:910-848-5439
Is Sole Proprietor?:No
Enumeration Date:2009-11-15
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC208505163W00000X
NC5004571363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse