Provider Demographics
NPI:1396845483
Name:MELKO, JUANITA MEADS (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:MEADS
Last Name:MELKO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 POINTE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-9116
Mailing Address - Country:US
Mailing Address - Phone:252-330-4079
Mailing Address - Fax:252-337-6792
Practice Address - Street 1:711 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-5643
Practice Address - Country:US
Practice Address - Phone:252-338-4400
Practice Address - Fax:252-337-6792
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101908163WC1500X, 163WE0003X
NC5007165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency