Provider Demographics
NPI:1891392510
Name:LYNCH, MELISSA G (RN, FNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:G
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3081
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28070-3081
Mailing Address - Country:US
Mailing Address - Phone:704-473-5263
Mailing Address - Fax:704-731-0961
Practice Address - Street 1:19401 OLD JETTON RD STE 100
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6575
Practice Address - Country:US
Practice Address - Phone:704-473-5263
Practice Address - Fax:704-731-0961
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC161396363LF0000X, 163W00000X
NC5013654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse