Basic Information
| Provider Information | |||||||||
| NPI: | 1922450741 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOWNSEND | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | FAYE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1406 KASLO CIR NW | ||||||||
| Address2: | |||||||||
| City: | PALM BAY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329078076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125412003 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4450 W EU GALLIE BLVD | ||||||||
| Address2: | STE 250 | ||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3217516671 | ||||||||
| FaxNumber: | 9044933395 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2016 | ||||||||
| LastUpdateDate: | 07/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN9366161 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.