Provider Demographics
NPI:1033623772
Name:SWIHART, MELISSA L (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:L
Last Name:SWIHART
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:SLATTERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4035 ELECTRIC RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8449
Mailing Address - Country:US
Mailing Address - Phone:540-772-8670
Mailing Address - Fax:540-772-7901
Practice Address - Street 1:4035 ELECTRIC RD STE A
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-8449
Practice Address - Country:US
Practice Address - Phone:540-772-8670
Practice Address - Fax:540-772-7901
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110006441363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant