Provider Demographics
NPI:1508642547
Name:MELTON, JACQUELYN ELIZABETH (FNP-C)
Entity type:Individual
Prefix:MISS
First Name:JACQUELYN
Middle Name:ELIZABETH
Last Name:MELTON
Suffix:
Gender:F
Credentials:FNP-C
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Other - Credentials:
Mailing Address - Street 1:805 W CARY ST APT 408
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-5414
Mailing Address - Country:US
Mailing Address - Phone:804-380-8567
Mailing Address - Fax:
Practice Address - Street 1:805 W CARY ST APT 408
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-5414
Practice Address - Country:US
Practice Address - Phone:804-380-8567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY356034363LF0000X
SC30747363LF0000X
CA95035155363LF0000X
VA0024188030363LF0000X
AR234346363LF0000X
OHAPRN.CNP.0039789363LF0000X
AZ322858363LF0000X
IN771016338A363LF0000X
OK220974363LF0000X
COC-APN.0103162-C-NP363LF0000X
NC5021960363LF0000X
TX1180527363LF0000X
GAGAA-NP003139363LF0000X
IL209.033873363LF0000X
MO2024047623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily