Healthcare Provider Details

I. General information

NPI: 1023365335
Provider Name (Legal Business Name): MELISSA BRAUN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HOSPITAL DR
WARRENTON VA
20186-3027
US

IV. Provider business mailing address

5980 10TH RD N
ARLINGTON VA
22205-1640
US

V. Phone/Fax

Practice location:
  • Phone: 540-316-4023
  • Fax:
Mailing address:
  • Phone: 614-560-5808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number0024169633
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: