Provider Demographics
NPI:1578972667
Name:COLE, MELISSA (NP)
Entity Type:Individual
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First Name:MELISSA
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:145 KIMEL PARK DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6984
Mailing Address - Country:US
Mailing Address - Phone:336-765-6181
Mailing Address - Fax:336-765-8492
Practice Address - Street 1:6371 JESSIE LN
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9887
Practice Address - Country:US
Practice Address - Phone:336-740-9060
Practice Address - Fax:336-740-9659
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2023-08-24
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Provider Licenses
StateLicense IDTaxonomies
NC5007002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily