Provider Demographics
NPI:1992132369
Name:WINCHELL, MELISSA (NP-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:BOWLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14121 PARKE LONG CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1647
Mailing Address - Country:US
Mailing Address - Phone:571-512-7287
Mailing Address - Fax:800-752-2471
Practice Address - Street 1:14121 PARKE LONG CT
Practice Address - Street 2:SUITE 201
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1647
Practice Address - Country:US
Practice Address - Phone:571-512-7287
Practice Address - Fax:800-752-2471
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily