MEDICARE: MELISSA BYRNE NELSON MD

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	208000000X	Pediatrics Physician	0101236198	VA

General Provider Information

NPI Number	:	1376505602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA BYRNE NELSON MD

Provider Business Mailing Address
First Line	:	412 LIBBIE AVE STE 104
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-2658
Country	:	US
Telephone Number	:	804-286-2195
Fax Number	:	804-286-2195

Provider Business Practice Location Address
First Line	:	412 LIBBIE AVE STE 104
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-2658
Country	:	US
Telephone Number	:	804-286-2195
Fax Number	:	804-286-2195

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	07/03/2025

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