Healthcare Provider Details

I. General information

NPI: 1518680834
Provider Name (Legal Business Name): MELISSA NARANJO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 JONES ST
SPRINGFIELD TN
37172-3718
US

IV. Provider business mailing address

1609 JONES ST
SPRINGFIELD TN
37172-3718
US

V. Phone/Fax

Practice location:
  • Phone: 615-433-8201
  • Fax: 615-433-8202
Mailing address:
  • Phone: 615-433-8201
  • Fax: 615-433-8202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11021690
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number36079
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: