1598954216 NPI number — MRS. MELISSA ANN LEVENS ARNP

Table of content: MRS. MELISSA ANN LEVENS ARNP (NPI 1598954216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598954216 NPI number — MRS. MELISSA ANN LEVENS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEVENS
Provider First Name:
MELISSA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598954216
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1175 CREEKSIDE PKWY
Provider Second Line Business Mailing Address:
UNIT 200
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34108-1943
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-284-4333
Provider Business Mailing Address Fax Number:
239-260-5036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1175 CREEKSIDE PKWY
Provider Second Line Business Practice Location Address:
UNIT 200
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34108-1943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-284-4333
Provider Business Practice Location Address Fax Number:
239-260-5036
Provider Enumeration Date:
10/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP 9242042 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ARNP 9242042 . This is a "STATE LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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