Healthcare Provider Details

I. General information

NPI: 1982924049
Provider Name (Legal Business Name): NEISHA T MULCHAN APRNFNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NEISHA TAMASI MULCHAN APRN FNP-C

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 S HIAWASSEE RD
ORLANDO FL
32835-8746
US

IV. Provider business mailing address

1415 W HOBSONWAY
BLYTHE CA
92225-1479
US

V. Phone/Fax

Practice location:
  • Phone: 407-740-0079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95017993
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberAPRN9222221
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9222221
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9222221
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: