Provider Demographics
NPI:1013743335
Name:MELGAR, ROSELYN (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:ROSELYN
Middle Name:
Last Name:MELGAR
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-4384
Mailing Address - Country:US
Mailing Address - Phone:304-725-6575
Mailing Address - Fax:
Practice Address - Street 1:1263 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425
Practice Address - Country:US
Practice Address - Phone:304-725-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR235581363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care