Provider Demographics
NPI:1982924049
Name:MULCHAN, NEISHA T (APRNFNP-C)
Entity type:Individual
Prefix:MS
First Name:NEISHA
Middle Name:T
Last Name:MULCHAN
Suffix:
Gender:
Credentials:APRNFNP-C
Other - Prefix:
Other - First Name:NEISHA
Other - Middle Name:TAMASI
Other - Last Name:MULCHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN FNP-C
Mailing Address - Street 1:1415 W HOBSONWAY
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-1479
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2295 S HIAWASSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-8746
Practice Address - Country:US
Practice Address - Phone:407-740-0079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017993363LF0000X
FLAPRN9222221163WP0808X, 363LP0808X
FLARNP9222221363LF0000X
FL9222221363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9222221OtherAPRN LICENSE
CA95017993OtherAPRN CA
CA95253346OtherREGISTERED NURSE CA
FLRN9222221OtherREGISTERED NURSE