Healthcare Provider Details

I. General information

NPI: 1528562030
Provider Name (Legal Business Name): MELISSA J NOBLITT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 HENDRY ST
FORT MYERS FL
33901-3020
US

IV. Provider business mailing address

1820 HENDRY ST
FORT MYERS FL
33901-3020
US

V. Phone/Fax

Practice location:
  • Phone: 239-496-0480
  • Fax: 844-749-1345
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11013385
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71007851A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: