Provider Demographics
NPI:1942618129
Name:BARBER, MELINDA LYNN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:LYNN
Last Name:BARBER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5570 COUGAR TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:VA
Mailing Address - Zip Code:24084-3849
Mailing Address - Country:US
Mailing Address - Phone:540-674-4560
Mailing Address - Fax:540-674-4713
Practice Address - Street 1:5570 COUGAR TRAIL RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-3849
Practice Address - Country:US
Practice Address - Phone:540-674-4560
Practice Address - Fax:540-674-4713
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171758363L00000X
TN18886363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1942618129Medicaid
VA1942618129Medicaid
VAP01535285Medicare PIN