Provider Demographics
NPI:1528623600
Name:NADENIK, MELISSA (NP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:NADENIK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:BALLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2902 SE 27TH CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0806
Mailing Address - Country:US
Mailing Address - Phone:352-484-9000
Mailing Address - Fax:
Practice Address - Street 1:2902 SE 27TH CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0806
Practice Address - Country:US
Practice Address - Phone:352-484-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-05
Last Update Date:2019-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002261363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner