Individual provider · NPI-1

Melissa Renee Broske, APRN

Nurse Practitioner, Family · Evans, GA

NPI number1184190647
StatusActive
Last updated in NPPESOct 9, 2025

Details

NPI
1184190647
Entity type
Individual (NPI-1)
Name
Melissa Renee Broske
Credential
APRN
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 22, 2018
Certification date
Oct 9, 2025
Last updated
Oct 9, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyNP217143GAYes

Other names

  • Melissa Renee Thakore (Former Name)

Practice location

614 Mullins Colony Dr
Evans, GA 30809-0579

Phone 706-760-7272 · Fax 706-760-7276

Mailing address

614 Mullins Colony Dr
Evans, GA 30809-0579

Phone 706-760-7272 · Fax 706-760-7276

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