MEDICARE: VELENCIA DAVIS MELLS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN216786	GA

General Provider Information

NPI Number	:	1427912989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VELENCIA DAVIS MELLS RN

Provider Business Mailing Address
First Line	:	4479 NEW JESUP HWY STE 103
Second Line	:	1048 MITCHELL CIRCLE SE
City	:	BRUNSWICK
State	:	GA
Zip	:	31520-1693
Country	:	US
Telephone Number	:	912-275-7114
Fax Number	:	912-342-7261

Provider Business Practice Location Address
First Line	:	4479 NEW JESUP HWY STE 103
Second Line	:
City	:	BRUNSWICK
State	:	GA
Zip	:	31520-1693
Country	:	US
Telephone Number	:	912-275-7114
Fax Number	:	912-342-7261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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