Provider Demographics
NPI:1033628581
Name:POWIDZKI, MELISSA REBECCA (PA-C, CAQ-PSYCH)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:REBECCA
Last Name:POWIDZKI
Suffix:
Gender:F
Credentials:PA-C, CAQ-PSYCH
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:REBECCA
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, CAQ-PSYCH
Mailing Address - Street 1:220 5TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-4377
Mailing Address - Country:US
Mailing Address - Phone:828-692-4289
Mailing Address - Fax:828-696-1794
Practice Address - Street 1:2579 CHIMNEY ROCK RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-9181
Practice Address - Country:US
Practice Address - Phone:828-692-4289
Practice Address - Fax:828-696-1794
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7553363A00000X
NC0010-11130363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant