Healthcare Provider Details

I. General information

NPI: 1477498699
Provider Name (Legal Business Name): MELODY HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 HALTONSHIRE WAY
GLEN ALLEN VA
23059-4836
US

IV. Provider business mailing address

11500 HALTONSHIRE WAY
GLEN ALLEN VA
23059-4836
US

V. Phone/Fax

Practice location:
  • Phone: 804-665-8651
  • Fax:
Mailing address:
  • Phone: 804-665-8651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL NONSO ENWELUM
Title or Position: NURSE PRACTITIONER
Credential: PMHNP-C
Phone: 804-665-8651