Provider Demographics
NPI:1912049966
Name:MCLAMB, MELISSA J (FNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:MCLAMB
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 EAST CORNEILUS HARNETT BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-9335
Mailing Address - Country:US
Mailing Address - Phone:910-814-6248
Mailing Address - Fax:910-893-7506
Practice Address - Street 1:307 W CORNELIUS HARNETT BLVD
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-9335
Practice Address - Country:US
Practice Address - Phone:910-814-6248
Practice Address - Fax:910-893-7506
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201776363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC3404456Medicaid
NC07212OtherBCBS
NC183296OtherMEDCOST
NCNC3404343Medicaid
NCNC3404456Medicaid