Provider Demographics
NPI:1699950345
Name:RANALLO, MELISSA LAUREN (PA-C)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LAUREN
Last Name:RANALLO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9930 KINCEY AVE STE 175
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6541
Mailing Address - Country:US
Mailing Address - Phone:704-885-5655
Mailing Address - Fax:833-973-5714
Practice Address - Street 1:9930 KINCEY AVE STE 175
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6541
Practice Address - Country:US
Practice Address - Phone:038-885-5655
Practice Address - Fax:833-973-5714
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2025-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-01188363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2759021Medicare PIN