Provider Demographics
NPI:1144658014
Name:LEMNAH, MELISSA LEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEIGH
Last Name:LEMNAH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 PARK RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8538
Mailing Address - Country:US
Mailing Address - Phone:704-541-8207
Mailing Address - Fax:
Practice Address - Street 1:10650 PARK RD
Practice Address - Street 2:SUITE 320
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210
Practice Address - Country:US
Practice Address - Phone:704-541-8207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05372363A00000X
AZ5562363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant