Provider Demographics
NPI:1457612012
Name:MELTON, ALLISON RENEE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:RENEE
Last Name:MELTON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:RENEE
Other - Last Name:ROANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:308 US HIGHWAY 17 N
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-7828
Mailing Address - Country:US
Mailing Address - Phone:910-329-1707
Mailing Address - Fax:910-329-1716
Practice Address - Street 1:308 US HIGHWAY 17 N
Practice Address - Street 2:
Practice Address - City:HOLLY RIDGE
Practice Address - State:NC
Practice Address - Zip Code:28445-7828
Practice Address - Country:US
Practice Address - Phone:910-329-1707
Practice Address - Fax:910-329-1716
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily