Provider Demographics
NPI:1457696494
Name:VANN-COMBS, MELISSA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:VANN-COMBS
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 1:2678 BOLIVER RD
Mailing Address - Street 2:
Mailing Address - City:FORT VALLEY
Mailing Address - State:VA
Mailing Address - Zip Code:22652-2424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2678 BOLIVER RD
Practice Address - Street 2:
Practice Address - City:FORT VALLEY
Practice Address - State:VA
Practice Address - Zip Code:22652-2424
Practice Address - Country:US
Practice Address - Phone:540-933-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002056040164W00000X
VA0024183794363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse