Active NPI
Melissa Leigh Bracewell, PHARMD
- Pharmacist
- Crestview, FL
National Provider Identifier
1376668848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS37073
- Practice address
- 1326 N Ferdon Blvd
Crestview, FL 32536-1714 - Phone
- (850) 689-1556
- Fax
- (850) 689-1504
- NPI assigned
- Mar 20, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS37073 | FL | Primary |
Addresses
Primary practice location
1326 N Ferdon Blvd
Crestview, FL 32536-1714
Mailing address
6132 Hacienda LN
Crestview, FL 32536-9329
Phone (850) 682-6422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS37073 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376668848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6132 HACIENDA LN",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325369329",
"telephone_number": "850-682-6422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1326 N FERDON BLVD",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325361714",
"telephone_number": "850-689-1556",
"fax_number": "850-689-1504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACEWELL",
"first_name": "MELISSA",
"middle_name": "LEIGH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS37073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.