Provider Demographics
NPI:1184900227
Name:METELSKY, LAURIE B (NP)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:B
Last Name:METELSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:B
Other - Last Name:METELSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1776 PRINCESS ANNE RD STE C
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-3857
Mailing Address - Country:US
Mailing Address - Phone:757-324-9591
Mailing Address - Fax:
Practice Address - Street 1:1776 PRINCESS ANNE RD STE C
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-3857
Practice Address - Country:US
Practice Address - Phone:727-324-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169715363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health