MEDICARE: MELISSA N. CLAYTON A.N.P.

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	363LA2200X	Adult Health Nurse Practitioner	002400059	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C06695	OTHER	VA	GROUP PTAN
2	C09633	OTHER	VA	GROUP PTAN

General Provider Information

NPI Number	:	1548298847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA N. CLAYTON A.N.P.

Provider Business Mailing Address
First Line	:	PO BOX 639970
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-9970
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11601 IRON BRIDGE RD
Second Line	:	SUITE 117
City	:	CHESTER
State	:	VA
Zip	:	23831-1466
Country	:	US
Telephone Number	:	804-717-5300
Fax Number	:	804-748-7269

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	01/21/2025

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