Provider Demographics
NPI:1205378403
Name:MILTCHEVA, ANELIYA
Entity Type:Individual
Prefix:
First Name:ANELIYA
Middle Name:
Last Name:MILTCHEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 FIRST COLONIAL RD STE A
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3078
Mailing Address - Country:US
Mailing Address - Phone:757-395-1850
Mailing Address - Fax:
Practice Address - Street 1:1020 FIRST COLONIAL RD STE A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3078
Practice Address - Country:US
Practice Address - Phone:757-395-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-06
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4880363LP0808X
VA0024182202363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner