Provider Demographics
NPI:1255322954
Name:PALMER, MELISSA J (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:PALMER
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 NC HIGHWAY 42 W
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-7434
Mailing Address - Country:US
Mailing Address - Phone:919-241-7734
Mailing Address - Fax:919-879-8625
Practice Address - Street 1:922 NC HIGHWAY 42 W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-7434
Practice Address - Country:US
Practice Address - Phone:919-241-7734
Practice Address - Fax:919-879-8625
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC863237700000X
NC4289231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC#01629OtherBCBS
NC863OtherNC HEARING AID DEALERS AN
NC2723803OtherAETNA
NC7614311OtherAETNA
NC9008165OtherPHCS
NCA6876OtherMEDCOST
NC4289OtherBOARD OF EXAMINERS SPEECH
NC7411162Medicaid
NC9008165OtherPHCS