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NPI 1013754613

NPI 1013754613 : MELVIN NEELEY DNP-FNP : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1013754613
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    Entity Type          |    Individual 
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    Provider Name        |    MELVIN NEELEY DNP-FNP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/10/2024
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    Last Update Date     |    07/10/2024
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Provider Practice Location Address
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    Address Line         |    655 W 8TH ST 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32209-6511
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    Country              |    US
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    Telephone            |    904-244-0411
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    95 BUSH PL 
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    City                 |    SAINT JOHNS
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    State                |    FL
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    Zip                  |    32259-7100
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    Country              |    US
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    Telephone            |    912-332-3221
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    F06240239
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    License Number State |    FL
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