MEDICARE: MELISSA SHAW NP

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	363LF0000X	Family Nurse Practitioner	0024182318	VA

General Provider Information

NPI Number	:	1184398505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA SHAW NP

Provider Business Mailing Address
First Line	:	7650 E PARHAM RD STE 210
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4306
Country	:	US
Telephone Number	:	804-272-2702
Fax Number	:	804-747-9050

Provider Business Practice Location Address
First Line	:	7650 E PARHAM RD STE 210
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4306
Country	:	US
Telephone Number	:	804-272-2702
Fax Number	:

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

Provider Enumeration Date	:	08/09/2021
Last Update Date	:	06/29/2022

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Directions to “ MELISSA SHAW NP” Practice Location

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