Healthcare Provider Details

I. General information

NPI: 1881980043
Provider Name (Legal Business Name): JENNIFER MARGO GREENFIELD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER SCHNEIDER WELDON APRN, FNP-BC

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6013 FARCENDA PL STE 102
MELBOURNE FL
32940-7331
US

IV. Provider business mailing address

2682 ADDISON DR
MELBOURNE FL
32940-7818
US

V. Phone/Fax

Practice location:
  • Phone: 321-655-5515
  • Fax: 321-241-4312
Mailing address:
  • Phone: 321-960-4186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9269354
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9269354
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: