Provider Demographics
NPI:1912217712
Name:JAMES, MELVIN WADE II (APRN)
Entity Type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:WADE
Last Name:JAMES
Suffix:II
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:200 TARPON TRL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5287
Mailing Address - Country:US
Mailing Address - Phone:910-938-1114
Mailing Address - Fax:910-938-1118
Practice Address - Street 1:200 TARPON TRL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5287
Practice Address - Country:US
Practice Address - Phone:910-938-1114
Practice Address - Fax:910-938-1118
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004925363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health