Individual
MELISSA JENNY OTHMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
600 GRESHAM DR STE 8620, NORFOLK, VA 23507-1904
(757) 395-1600
(757) 625-0433
Mailing address
600 GRESHAM DR STE 8620, NORFOLK, VA 23507-1904
(757) 395-1600
(757) 625-0433
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004967
VA
363AM0700X
Medical Physician Assistant
017686
NY
Other
Enumeration date
07/08/2014
Last updated
01/10/2024
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