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General NPI Number Information
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NPI Number | 1699230508
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Entity Type | Individual
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Provider Name | MELISSA MULLINS GREENSPAN APRN
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Gender | Female
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 1155 KELLY JOHNSON BLVD STE 111
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3957
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Country | US
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Telephone | 415-403-2156
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 COLLEGE PKWY STE 1061
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City | GULF BREEZE
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State | FL
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Zip | 32563-2711
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Country | US
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Telephone | 850-396-4198
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Fax | 850-299-9093
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11001293
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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 | C-APN.0003562-C-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1067979
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11001293
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License Number State | FL
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