Provider Demographics
NPI:1336234475
Name:DONGHIA, MELANIE MARY (CRNA)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:MARY
Last Name:DONGHIA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:GORELLI-DONGHIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 535395
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-5321
Mailing Address - Country:US
Mailing Address - Phone:919-873-9533
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:4420 LAKE BOONE TRL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7505
Practice Address - Country:US
Practice Address - Phone:919-784-3034
Practice Address - Fax:919-784-1471
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1622632367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered