Provider Demographics
NPI:1922883180
Name:MELTON, CAROLINE WILLIAMS
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:WILLIAMS
Last Name:MELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:MARIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1420 MIDTOWN AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3755
Mailing Address - Country:US
Mailing Address - Phone:843-834-5192
Mailing Address - Fax:
Practice Address - Street 1:25 COURTENAY DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8911
Practice Address - Country:US
Practice Address - Phone:843-792-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC244905163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse