Provider Demographics
NPI:1487137840
Name:WOODY, MELISSA LYNN (PA-C)
Entity type:Individual
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First Name:MELISSA
Middle Name:LYNN
Last Name:WOODY
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:43 WHITING HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1006
Mailing Address - Country:US
Mailing Address - Phone:207-973-5000
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:1 NORTHEAST DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4332
Practice Address - Country:US
Practice Address - Phone:207-275-3800
Practice Address - Fax:207-275-3836
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
MEPA377363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant