Provider Demographics
NPI:1376724393
Name:MAST, MELODY M (CNM)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:M
Last Name:MAST
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:119 UNIVERSITY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3753
Mailing Address - Country:US
Mailing Address - Phone:540-575-5245
Mailing Address - Fax:540-217-2467
Practice Address - Street 1:119 UNIVERSITY BLVD STE B
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3753
Practice Address - Country:US
Practice Address - Phone:540-575-5245
Practice Address - Fax:540-217-2467
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024167585363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health