Healthcare Provider Details

I. General information

NPI: 1497630271
Provider Name (Legal Business Name): DONNITA MICHELLE LAW ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KNOTBREAK RD
SALEM VA
24153-5414
US

IV. Provider business mailing address

100 KNOTBREAK RD
SALEM VA
24153-5414
US

V. Phone/Fax

Practice location:
  • Phone: 540-444-5670
  • Fax: 540-444-5669
Mailing address:
  • Phone: 540-444-5670
  • Fax: 540-444-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number0024194112
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024194112
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: