Melillo, Jennifer L

Melillo, Jennifer L is an individual health care provider with primary practice located at 6275 E Virginia Beach Blvd Ste 300 , Norfolk VA 23502-2851. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Melillo, Jennifer L can be contacted via phone (757) 961-0606.

Contact Information

Primary practice address
6275 E Virginia Beach Blvd Ste 300 Norfolk VA 23502-2851
Phone: (757) 961-0606
Fax: (757) 233-8499
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 0001160085 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024169372 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 0024169372 Virginia

Profile Details

NPI number 1629139878
LBN Legal business name Melillo, Jennifer L
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Mar 27th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629139878 NPPES
Virginia MEDICAID 1629139878

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