Angela Dawn Mellen, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11028523 Issued in FL

Practice address

142 N Cory Dr
Edgewater, FL 32141-7226

Phone

(386) 366-1780

NPI assigned

Sep 11, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1992582316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 N CORY DR",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321417226",
            "telephone_number": "386-366-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 N CORY DR",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321417226",
            "telephone_number": "386-366-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLEN",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11028523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kaley Melville
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• Mindful Healing Counseling Services
• Minim Inc.

• Family Nurse Practitioner in Edgewater, FL
• Providers in Edgewater, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.