Provider Demographics
NPI:1023859766
Name:STEPHENS, MELISSA (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2928 BYWATER DR APT 132
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-6606
Mailing Address - Country:US
Mailing Address - Phone:781-307-0151
Mailing Address - Fax:
Practice Address - Street 1:8324 BELL CREEK RD STE 100
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3848
Practice Address - Country:US
Practice Address - Phone:804-522-5500
Practice Address - Fax:804-522-5501
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-08-08
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Provider Licenses
StateLicense IDTaxonomies
VA0110010083363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant