Provider Demographics
NPI:1427477199
Name:BOXLEY, MELODY E (FNP)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:E
Last Name:BOXLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-0004
Mailing Address - Country:US
Mailing Address - Phone:804-728-2278
Mailing Address - Fax:804-728-2329
Practice Address - Street 1:5100 TOOLEY DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-6644
Practice Address - Country:US
Practice Address - Phone:804-728-2278
Practice Address - Fax:824-728-2329
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171453363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily