Provider Demographics
NPI:1548575699
Name:WEDDLE, MICHELLE ELAINE (FNP)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ELAINE
Last Name:WEDDLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 CROSSWAYS BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-0207
Mailing Address - Country:US
Mailing Address - Phone:757-620-4798
Mailing Address - Fax:757-953-6329
Practice Address - Street 1:1400 CROSSWAYS BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0207
Practice Address - Country:US
Practice Address - Phone:757-953-6366
Practice Address - Fax:757-953-6329
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily