| Doctor Name: | MELISSA ANNE COUSINS |
| NPI Number: | 1396821724 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 5004311 |
| Business Practice Address: | 670 W Academy St Randleman, NC - 273179748 |
| Business Phone Number: | 3364953186 |
| Business Fax Number: | 3364953390 |
| Mailing Address: | 218 Foust St Ste C, ASHEBORO |
| State: | NC |
| Postal Code: | 272035476 |
| Phone Number: | 3366256072 |
| Fax Number: | 3366255511 |
| NPI Enumeration Date: | 10/27/2006 |
| NPI Last Update Date: | 12/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5004311 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |