Individual
MELANIE LYN WIEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4500 POND WAY STE 170, WOODBRIDGE, VA 22192-5596
(571) 542-4950
(571) 285-1160
Mailing address
12006 KILARNEY DR, FREDERICKSBURG, VA 22407-7207
(540) 786-9771
(540) 548-8803
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024172873
VA
363LA2200X
Adult Health Nurse Practitioner
5005287
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104108554
—
VA
05
—
7005557
—
NC
Enumeration date
09/12/2011
Last updated
09/02/2022
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