Provider Demographics
NPI:1609386846
Name:STAYKOVA, MILENA PETROVA (EDD, APRN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:MILENA
Middle Name:PETROVA
Last Name:STAYKOVA
Suffix:
Gender:F
Credentials:EDD, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6219 STONE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-7909
Mailing Address - Country:US
Mailing Address - Phone:540-525-9310
Mailing Address - Fax:540-224-4785
Practice Address - Street 1:101 ELM AVE SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24013-2222
Practice Address - Country:US
Practice Address - Phone:540-985-8261
Practice Address - Fax:540-224-4785
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily