Provider Demographics
NPI:1699700237
Name:PETCHEL, MELANIE M (CPNP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:M
Last Name:PETCHEL
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 DISCOVERY DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3871
Mailing Address - Country:US
Mailing Address - Phone:757-668-2500
Mailing Address - Fax:757-668-2510
Practice Address - Street 1:500 DISCOVERY DR
Practice Address - Street 2:SUITE 302
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3871
Practice Address - Country:US
Practice Address - Phone:757-668-2500
Practice Address - Fax:757-668-2510
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164776363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7789688Medicaid
VA44700NOtherOPTIMA,FAMILY CARE, FAMIS
VA541778786OtherNC HEALTH