Provider Demographics
NPI:1447245741
Name:ATKINS, MELISSA A (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-0149
Mailing Address - Country:US
Mailing Address - Phone:540-459-3753
Mailing Address - Fax:540-459-8928
Practice Address - Street 1:103 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1238
Practice Address - Country:US
Practice Address - Phone:540-459-3753
Practice Address - Fax:540-459-8928
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001728363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010042747Medicaid
VA002649W34Medicare ID - Type UnspecifiedMEDICARE
VAP61396Medicare UPIN