Provider Demographics
NPI:1487295895
Name:EATMON, MELISSA NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:NICOLE
Last Name:EATMON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 GREENVILLE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5102
Mailing Address - Country:US
Mailing Address - Phone:252-756-4682
Mailing Address - Fax:
Practice Address - Street 1:705 GREENVILLE BLVD SE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5102
Practice Address - Country:US
Practice Address - Phone:252-756-4682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist