Healthcare Provider Details

I. General information

NPI: 1023949500
Provider Name (Legal Business Name): MELISSA BRINKLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2349 VILLAGE SQUARE PKWY STE 110-111
FLEMING ISLAND FL
32003-6355
US

IV. Provider business mailing address

23476 NW 186TH AVE
HIGH SPRINGS FL
32643-0673
US

V. Phone/Fax

Practice location:
  • Phone: 904-385-2023
  • Fax:
Mailing address:
  • Phone: 386-454-0698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11047019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: