Provider Demographics
NPI:1245838267
Name:QUEEN, MISTY SPRING (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:MISTY
Middle Name:SPRING
Last Name:QUEEN
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:VA
Mailing Address - Zip Code:24084-3211
Mailing Address - Country:US
Mailing Address - Phone:540-674-8805
Mailing Address - Fax:540-674-8670
Practice Address - Street 1:901 PLANTATION RD
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-3880
Practice Address - Country:US
Practice Address - Phone:540-951-0352
Practice Address - Fax:540-951-7724
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily