Provider Demographics
NPI:1386312353
Name:AULL, MELISSA KAREN (PMHNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAREN
Last Name:AULL
Suffix:
Gender:F
Credentials:PMHNP
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Other - Credentials:
Mailing Address - Street 1:34650 US HIGHWAY 19 N STE 206
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2157
Mailing Address - Country:US
Mailing Address - Phone:833-769-3524
Mailing Address - Fax:727-939-6062
Practice Address - Street 1:34650 US HIGHWAY 19 N STE 206
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2157
Practice Address - Country:US
Practice Address - Phone:833-769-3524
Practice Address - Fax:727-939-6062
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015487363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024182623OtherSTATE LICENSE
FLAPRN11015847OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH