Provider Demographics
NPI:1144080805
Name:MELTON, GRETA (FNP)
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:MELTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:GRETA
Other - Middle Name:
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1557
Mailing Address - Country:US
Mailing Address - Phone:630-573-5000
Mailing Address - Fax:630-491-5472
Practice Address - Street 1:504 N MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3636
Practice Address - Country:US
Practice Address - Phone:850-769-2158
Practice Address - Fax:850-785-9220
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9477473363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily