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NPI Code Detail

MEDICARE: MELISSA MARIE SENIOR ARNP

MEDICARE: MELISSA MARIE SENIOR ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerARNP9218049FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518224443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MARIE SENIOR ARNP
Provider Business Mailing Address
First Line : PO BOX 44008
Second Line : UFJP - PROVIDER ENROLLMENT
City : JACKSONVILLE
State : FL
Zip : 32231-4008
Country : US
Telephone Number : 904-244-3199
Fax Number : 904-244-3425
Provider Business Practice Location Address
First Line : 1155 E 21ST ST
Second Line : UFJP - ELIZABETH G. MEANS COMMUNITY HEALTH CENTER
City : JACKSONVILLE
State : FL
Zip : 32206-2401
Country : US
Telephone Number : 904-633-0500
Fax Number : 904-359-9623
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2012
Last Update Date : 04/01/2014

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Directions to “ MELISSA MARIE SENIOR ARNP” Practice Location

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