Individual
MS. MELANIE A COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3600 JOSEPH SIEWICK DR, FAIRFAX, VA 22033-1709
(703) 391-3600
Mailing address
68 S SERVICE RD, SUITE 350, MELVILLE, NY 11747
(516) 945-3107
(516) 945-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024117317
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139180
ANTHEM
VA
05
—
1811077266
—
VA
01
—
420042674
RAILROAD MEDICARE
VA
01
—
484645
NCPPO
VA
01
—
K142-0002
CAREFIRST
DC
Enumeration date
10/17/2006
Last updated
04/05/2016
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