Provider Demographics
NPI:1053910216
Name:SCAGGS, MELANIE ANN (RN)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:SCAGGS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 CRICKET CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2805
Mailing Address - Country:US
Mailing Address - Phone:804-543-2524
Mailing Address - Fax:
Practice Address - Street 1:2100 CRICKET CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2805
Practice Address - Country:US
Practice Address - Phone:804-543-2524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001190336163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management