Provider Demographics
NPI:1871959049
Name:EDGER, MELINDA JO (MSN,RN,FNP-BC,CWOCN)
Entity type:Individual
Prefix:
First Name:MELINDA JO
Middle Name:
Last Name:EDGER
Suffix:
Gender:F
Credentials:MSN,RN,FNP-BC,CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:1830 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2808
Practice Address - Country:US
Practice Address - Phone:540-536-6547
Practice Address - Fax:540-536-4277
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015839363LF0000X
WV108388363LF0000X
VA0024180894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily