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General NPI Number Information
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NPI Number | 1770718678
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Entity Type | Individual
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Provider Name | MELISSA JANE BOYLE APRN
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Gender | Female
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Dates
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Enumeration Date | 05/20/2009
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 12058 SAN JOSE BLVD STE 1003
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City | JACKSONVILLE
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State | FL
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Zip | 32223-8667
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Country | US
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Telephone | 904-391-9875
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Fax | 904-321-9890
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Provider Business Mailing Address
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Address Line | 3948 3RD ST S STE 151
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-5847
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Country | US
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Telephone | 619-641-9776
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11007220
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9320462
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA35203
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License Number State | FL
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