Healthcare Provider Details

I. General information

NPI: 1083506398
Provider Name (Legal Business Name): MELISSA RENEE NELSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11123 COUNTY LINE RD
SPRING HILL FL
34609-5615
US

IV. Provider business mailing address

6329 STATE ROAD 54
NEW PORT RICHEY FL
34653-6037
US

V. Phone/Fax

Practice location:
  • Phone: 352-666-5555
  • Fax: 352-666-2915
Mailing address:
  • Phone: 727-844-5555
  • Fax: 727-844-5553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11040670
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: