MEDICARE: MELISSA LINEBURG

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	133N00000X	Nutritionist	DX6502	MD

General Provider Information

NPI Number	:	1104788751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA LINEBURG

Provider Business Mailing Address
First Line	:	8340 GREENSBORO DR UNIT 116
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3535
Country	:	US
Telephone Number	:	304-303-5911
Fax Number	:

Provider Business Practice Location Address
First Line	:	8340 GREENSBORO DR UNIT 116
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3535
Country	:	US
Telephone Number	:	304-303-5911
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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Directions to “ MELISSA LINEBURG ” Practice Location

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