Provider Demographics
NPI:1023326170
Name:TELFER, MELISSA KATHLEEN (ARNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:KATHLEEN
Last Name:TELFER
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 1:517 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-5520
Mailing Address - Country:US
Mailing Address - Phone:941-625-0600
Mailing Address - Fax:941-624-0941
Practice Address - Street 1:517 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-5520
Practice Address - Country:US
Practice Address - Phone:941-625-0600
Practice Address - Fax:941-624-0941
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9180125363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103164200Medicaid
FL424324OtherBCBS