Healthcare Provider Details

I. General information

NPI: 1255988770
Provider Name (Legal Business Name): MELISSA M KESTLER DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA M GAARD

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 PENNSYLVANIA AVE
SEAFORD DE
19973-3820
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 410-391-6131
  • Fax:
Mailing address:
  • Phone: 434-715-7834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0053677
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAC004126
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0001317
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: