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General NPI Number Information
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NPI Number | 1124131776
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Entity Type | Individual
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Provider Name | MELISSA L RUDD PMHNP, APRN, DNP
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 3522 SADDLE BACK LN
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City | LUTZ
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State | FL
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Zip | 33548-4765
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Country | US
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Telephone | 813-974-8900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 917770
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City | ORLANDO
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State | FL
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Zip | 32891-7770
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Country | US
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Telephone |
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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 | ARNP9350196
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60919272
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60919272
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP009149
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN9350196
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License Number State | FL
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