MEDICARE: DR. MELANIE D PARKS DNP, FNP, PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	0001140002	VA
2	363LF0000X	Family Nurse Practitioner	0024165998	VA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024165998	VA

General Provider Information

NPI Number	:	1538138342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE D PARKS DNP, FNP, PMHNP

Provider Business Mailing Address
First Line	:	55 COPPER BEACH CT
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-4155
Country	:	US
Telephone Number	:	540-241-3572
Fax Number	:	540-381-2441

Provider Business Practice Location Address
First Line	:	55 COPPER BEACH CT
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-4155
Country	:	US
Telephone Number	:	540-241-3572
Fax Number	:	540-381-2441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	03/30/2016

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