1124939616 NPI number — MELISSA LYNN JAMERSON MSN, APRN, FNP-C

Table of content: MELISSA LYNN JAMERSON MSN, APRN, FNP-C (NPI 1124939616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124939616 NPI number — MELISSA LYNN JAMERSON MSN, APRN, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JAMERSON
Provider First Name:
MELISSA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, APRN, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124939616
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11638 FARMVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEHERRIN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23954-3276
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-607-5187
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
833 BUFFALO ST STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23901-1111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-392-8177
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  0024198812 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)