Provider Demographics
NPI:1518380773
Name:MELVIN, TONISHA J (NP)
Entity Type:Individual
Prefix:DR
First Name:TONISHA
Middle Name:J
Last Name:MELVIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10421 MOTOR CITY DR STE 341334
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-9996
Mailing Address - Country:US
Mailing Address - Phone:706-504-6384
Mailing Address - Fax:
Practice Address - Street 1:10421 MOTOR CITY DR STE 341334
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-9996
Practice Address - Country:US
Practice Address - Phone:706-504-6384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN235296363L00000X
TX740463363L00000X
DCNP500002931363LP0808X, 363LA2200X
VA0024180646363LP2300X
MDR244933363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care