Provider Demographics
NPI:1548298847
Name:CLAYTON, MELISSA N (ANP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:N
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:NOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:PO BOX 639970
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11601 IRON BRIDGE RD
Practice Address - Street 2:SUITE 117
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1466
Practice Address - Country:US
Practice Address - Phone:804-717-5300
Practice Address - Fax:804-748-7269
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA002400059363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06695OtherGROUP PTAN
VAC09633OtherGROUP PTAN
VAC06695OtherGROUP PTAN
VAQ46652Medicare UPIN