Individual provider · Type 1 NPI

Melenda Jackson Moore, CSFA, CST

Surgical Assistant · Marietta, GA

NPI number 1831094226 Active

Practice location

55 Atlanta St SE Ste 204
Marietta, GA 30060-1977

Call (678) 517-3428 Map

Fax (770) 485-1534

Mailing address

2622 Memory Ln
Douglasville, GA 30135-4452

Specialties and licenses

Taxonomy	Code	License
Surgical Assistant Primary	246ZC0007X	202339 (GA)

Surgical Assistant: A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in h…

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About NPI 1831094226

Melenda Jackson Moore, CSFA, CST's National Provider Identifier is 1831094226, issued on Oct 14, 2026. The primary taxonomy on file is Surgical Assistant (246ZC0007X), and the practice location is in Marietta, GA. The record was last updated on Oct 14, 2026.