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NPI Code Detail

MEDICARE: MISS JACQUELYN ELIZABETH MELTON FNP-C

MEDICARE: MISS JACQUELYN ELIZABETH MELTON FNP-C
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
1363LF0000XFamily Nurse Practitioner356034NY
2363LF0000XFamily Nurse Practitioner30747SC
3363LF0000XFamily Nurse Practitioner95035155CA
4363LF0000XFamily Nurse Practitioner0024188030VA
5363LF0000XFamily Nurse Practitioner234346AR
6363LF0000XFamily Nurse PractitionerAPRN.CNP.0039789OH
7363LF0000XFamily Nurse Practitioner322858AZ
8363LF0000XFamily Nurse Practitioner771016338AIN
9363LF0000XFamily Nurse Practitioner220974OK
10363LF0000XFamily Nurse PractitionerC-APN.0103162-C-NPCO
11363LF0000XFamily Nurse Practitioner5021960NC
12363LF0000XFamily Nurse Practitioner1180527TX
13363LF0000XFamily Nurse PractitionerGAA-NP003139GA
14363LF0000XFamily Nurse Practitioner209.033873IL
15363LF0000XFamily Nurse Practitioner2024047623MO

General Provider Information

NPI Number : 1508642547
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JACQUELYN ELIZABETH MELTON FNP-C
Provider Business Mailing Address
First Line : 805 W CARY ST APT 408
Second Line :
City : RICHMOND
State : VA
Zip : 23220-5414
Country : US
Telephone Number : 804-380-8567
Fax Number :
Provider Business Practice Location Address
First Line : 805 W CARY ST APT 408
Second Line :
City : RICHMOND
State : VA
Zip : 23220-5414
Country : US
Telephone Number : 804-380-8567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2023
Last Update Date : 12/08/2025

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