Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 72761 | NC |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 72761 | NC |
NPI | 1003198946 |
---|---|
Provider Name | Ms. Melody Ann Watral |
First Address | Chapel Hill, NC 27599-0001 |
Second Address | Chapel Hill, NC 27514-4220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2011 |
Last Update Date | 21/08/2021 |