Provider Demographics
NPI:1760994800
Name:HUEY, MELANIE (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HUEY
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20706 US HIGHWAY 90 WEST
Mailing Address - Street 2:
Mailing Address - City:SANDERSON
Mailing Address - State:FL
Mailing Address - Zip Code:32087
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17128 US HIGHWAY 90 WEST
Practice Address - Street 2:
Practice Address - City:SANDERSON
Practice Address - State:FL
Practice Address - Zip Code:32087
Practice Address - Country:US
Practice Address - Phone:386-719-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3316212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily