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General NPI Number Information
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NPI Number | 1720822026
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Entity Type | Individual
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Provider Name | MELANIE ERIN JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 600 GRESHAM DR STE 1100
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City | NORFOLK
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State | VA
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Zip | 23507-1904
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Country | US
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Telephone | 757-388-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 529 SPRING LAKE CRES APT 302
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6423
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Country | US
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Telephone | 703-380-8252
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2201001976
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License Number State | VA
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