Provider Demographics
NPI:1366053993
Name:MILLER-THUWIS, MELISSA (FNP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MILLER-THUWIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13421 KIBWORTH LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-5721
Mailing Address - Country:US
Mailing Address - Phone:704-650-0319
Mailing Address - Fax:
Practice Address - Street 1:3333 WILKINSON BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5631
Practice Address - Country:US
Practice Address - Phone:704-393-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF03200309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily