Provider Demographics
NPI:1346036548
Name:ANDERSON, MELANIE (NP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 631767
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1767
Mailing Address - Country:US
Mailing Address - Phone:812-450-6815
Mailing Address - Fax:
Practice Address - Street 1:2710 HEARTLAND CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7674
Practice Address - Country:US
Practice Address - Phone:270-561-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71016539A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner