Provider Demographics
NPI:1124520622
Name:MCELFRESH, MELANY
Entity type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:MCELFRESH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 MALONEY RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KY
Mailing Address - Zip Code:41002-8993
Mailing Address - Country:US
Mailing Address - Phone:606-782-0719
Mailing Address - Fax:
Practice Address - Street 1:814 MADISON AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2414
Practice Address - Country:US
Practice Address - Phone:859-591-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator