Provider Demographics
NPI:1215493275
Name:DANIEL, MELANIE SABINE (NP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:SABINE
Last Name:DANIEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 BUYRN CIR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-6642
Mailing Address - Country:US
Mailing Address - Phone:757-406-1181
Mailing Address - Fax:
Practice Address - Street 1:301 RIVERVIEW AVE STE 500
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1066
Practice Address - Country:US
Practice Address - Phone:757-233-8252
Practice Address - Fax:757-233-8905
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily