Individual
MELISSA MACMINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21125 BAILEYS GROVE DR, SOUTH CHESTERFIELD, VA 23803-2256
(804) 475-3564
Mailing address
21125 BAILEYS GROVE DR, SOUTH CHESTERFIELD, VA 23803-2256
(804) 475-3564
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024179896
VA
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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