MEDICARE: MRS. MELANIE SHEAR APRN

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	163WG0600X	Gerontology Registered Nurse	9356288	FL
2	363LA2200X	Adult Health Nurse Practitioner	11009892	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972103919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELANIE SHEAR APRN

Provider Business Mailing Address
First Line	:	22 MACY LN
Second Line	:
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-5014
Country	:	US
Telephone Number	:	205-739-1908
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 SANDESTIN LN
Second Line	:
City	:	MIRAMAR BEACH
State	:	FL
Zip	:	32550-5815
Country	:	US
Telephone Number	:	850-267-2887
Fax Number	:

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

Provider Enumeration Date	:	10/29/2020
Last Update Date	:	07/01/2021

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