Provider Demographics
NPI:1508309527
Name:TAPSCOTT, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:TAPSCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NC
Mailing Address - Zip Code:27820-9645
Mailing Address - Country:US
Mailing Address - Phone:252-387-9008
Mailing Address - Fax:
Practice Address - Street 1:700 TERRACE LN
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NC
Practice Address - Zip Code:27820-9645
Practice Address - Country:US
Practice Address - Phone:252-387-9008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-066-021311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home