Individual
MS. MELISSA H SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1107A BROOKDALE ST, MARTINSVILLE, VA 24112-4501
(276) 629-1076
Mailing address
1107A BROOKDALE ST, MARTINSVILLE, VA 24112-4501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001-139024
VA
363LF0000X
Family Nurse Practitioner
Primary
0024-166024
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010177014
—
VA
Enumeration date
11/11/2005
Last updated
03/11/2020
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