Individual
DR. MELCHIZEDEK ROD KRESGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, APRN, PMHNP-BC
Contact information
Practice address
11204 WAPLES MILL RD, FAIRFAX, VA 22030-6036
(703) 218-8500
(703) 359-0463
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5741
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024177937
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024177937
VA
Other
Enumeration date
07/25/2019
Last updated
12/02/2022
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