Provider Demographics
NPI:1235436403
Name:TOUCHTON, MARY MELISSA (ARNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MELISSA
Last Name:TOUCHTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 N STONEY PT
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-9230
Mailing Address - Country:US
Mailing Address - Phone:352-228-0474
Mailing Address - Fax:
Practice Address - Street 1:1990 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-9792
Practice Address - Country:US
Practice Address - Phone:352-527-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9197708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily