Provider Demographics
NPI:1962245316
Name:FERRANTE-GENNARO, MELANIE ROSE (APRN)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ROSE
Last Name:FERRANTE-GENNARO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:GENNARO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12019 GRAND KEMPSTON DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-5367
Mailing Address - Country:US
Mailing Address - Phone:813-892-8696
Mailing Address - Fax:
Practice Address - Street 1:3301 W GANDY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-2931
Practice Address - Country:US
Practice Address - Phone:813-925-1903
Practice Address - Fax:813-749-8370
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL933473163W00000X
FLAPRN11034101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse