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Individual
MELISSA A VANAUSDOLL
Active
Individual
MELISSA A VANAUSDOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103382
NC
363AM0700X
Medical Physician Assistant
103382
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8101447
—
NC
Enumeration date
01/11/2006
Last updated
06/21/2013
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