Provider Demographics
NPI:1922766815
Name:COLEMAN, MELISSA (FNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:BLAND
Mailing Address - State:VA
Mailing Address - Zip Code:24315-5246
Mailing Address - Country:US
Mailing Address - Phone:276-389-7061
Mailing Address - Fax:
Practice Address - Street 1:8494 S SCENIC HWY
Practice Address - Street 2:
Practice Address - City:BLAND
Practice Address - State:VA
Practice Address - Zip Code:24315-5255
Practice Address - Country:US
Practice Address - Phone:276-688-0500
Practice Address - Fax:276-688-4336
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001210106163W00000X
VA0024184315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse