DR. MELISSA WAYBRANT-ENNIS APRN DNP PMHNP-BC NPI 1780118885

NPI Information

NPI: 1780118885
Provider Name: DR. MELISSA WAYBRANT-ENNIS, APRN, DNP, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1859 SW NEWLAND WAY
LAKE CITY, FL
ZIP 32025
Phone: (386) 758-0003
Get Directions

DR. Melissa Waybrant-ennis, APRN, DNP, PMHNP-BC is a psychiatric/mental health nurse practitioner in Lake City, FL. DR. Melissa Waybrant-ennis, APRN, DNP, PMHNP-BC NPI is 1780118885. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1859 SW NEWLAND WAY
LAKE CITY, FL
ZIP 32025-966
Phone: (386) 758-0003

The NPI 1780118885 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/14/2017 and was last updated on 9/28/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	11003223	FLORIDA	Yes
2	363L00000X	Nurse Practitioner		209015760	ILLINOIS	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	209015760	ILLINOIS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	104165900	MEDICAID	FLORIDA
2	209015760	OTHER	ILLINOIS	ADVANCED PRACTICE NURSE
3	11003223	OTHER	FLORIDA	APRN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »