Organization
MED SPA OFMIDDLEBURG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE LANE RN, MSN (OWNER)
(540) 316-7515
Entity
Organization
Contact information
Practice address
5 N. HAMILTON ST., MIDDLEBURG, VA 20117
(540) 883-3122
(540) 687-7003
Mailing address
PO BOX 544, MIDDLEBURG, VA 20118-0544
(540) 316-7515
(540) 687-7003
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
—
—
163WI0500X
Infusion Therapy Registered Nurse
—
—
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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