Individual
MICAH PACIFICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
949 PINEY FOREST RD, DANVILLE, VA 24540-1591
(434) 835-4876
(434) 835-4875
Mailing address
949 PINEY FOREST RD, DANVILLE, VA 24540-1591
(434) 835-4876
(434) 835-4875
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024178617
VA
363LF0000X
Family Nurse Practitioner
Primary
0024178617
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024178617
APPLIED NOT COMPLETE
VA
01
—
1225430648
NOT YET CREDENTIALED
VA
Enumeration date
12/26/2019
Last updated
02/25/2026
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