Provider Demographics
NPI:1689214736
Name:STALLINGS, MELISSA JORDAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JORDAN
Last Name:STALLINGS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 49092
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0073
Mailing Address - Country:US
Mailing Address - Phone:704-375-0404
Mailing Address - Fax:704-375-0705
Practice Address - Street 1:6419 CAROLINA BEACH RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-3671
Practice Address - Country:US
Practice Address - Phone:910-790-3660
Practice Address - Fax:910-790-9499
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-12-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant