Individual
MIRANDA NICOLE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2006 HEALTH CAMPUS DR STE 200, ROCKINGHAM, VA 22801-8679
(540) 689-5800
(757) 431-7136
Mailing address
2006 HEALTH CAMPUS DR STE 200, ROCKINGHAM, VA 22801-8679
(540) 689-5800
(757) 431-7136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110006882
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366003949
—
VA
Enumeration date
06/25/2019
Last updated
05/23/2023
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