Provider Demographics
NPI:1881752228
Name:BROWN-PATRAM, MELISSA JOYCE (ACNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JOYCE
Last Name:BROWN-PATRAM
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2001
Practice Address - Street 1:327 ROCK CRUSHER ROAD
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-8477
Practice Address - Country:US
Practice Address - Phone:336-636-5546
Practice Address - Fax:336-636-5145
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC960036174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00605577OtherRAILROAD MEDICARE
NC7000173Medicaid
NCP40610Medicare UPIN
NCP00605577OtherRAILROAD MEDICARE
NC7000173Medicaid