MELISSA RENEE BROSKE APRN
NPI 1184190647
Nurse Practitioner - Family in Evans, GA
Active since October 22, 2018
About Melissa Renee Broske Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MELISSA RENEE BROSKE APRN (NPI 1184190647) is an individual family provider in Evans, Georgia, licensed in Georgia (NP217143) and active in the NPI registry since October 2018.
NPPES Registry Identity
NPI1184190647
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMELISSA RENEE BROSKECredential: APRN
Location Address614 MULLINS COLONY DREvans, GA 30809-0579
Mailing Address614 Mullins Colony DrEvans, GA 30809-0579 · (706) 760-7272 · Fax (706) 760-7276
Phone(706) 760-7272
Fax(706) 760-7276
Sole ProprietorYes
Enumeration DateOctober 22, 2018
Last NPPES UpdateOctober 9, 20252 updates tracked since enumeration
NPPES CertifiedOctober 9, 2025
✔ NPI 1184190647 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · NP217143
614 MULLINS COLONY DR, Evans, GA 30809
Other Names 1
Former Name (1)Melissa Renee Thakore
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1184190647, enumerated as an "individual" on October 22, 2018.
The provider is located at 614 MULLINS COLONY DR EVANS, GA 30809 and the phone number is (706) 760-7272.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
