Provider Demographics
NPI:1699230508
Name:GREENSPAN, MELISSA MULLINS (APRN)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:MULLINS
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 COLLEGE PKWY STE 1061
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-2711
Mailing Address - Country:US
Mailing Address - Phone:850-396-4198
Mailing Address - Fax:850-299-9093
Practice Address - Street 1:1155 KELLY JOHNSON BLVD STE 111
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3957
Practice Address - Country:US
Practice Address - Phone:415-403-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001293363L00000X, 363LF0000X
COC-APN.0003562-C-NP363LF0000X
TX1067979363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner