Edds, Melissa Dawn

Edds, Melissa Dawn is an individual health care provider with primary practice located at 4402 Churchman Ave Ste 300 , Louisville KY 40215-3101. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Edds, Melissa Dawn can be contacted via phone (502) 363-0588.

Contact Information

Primary practice address
4402 Churchman Ave Ste 300 Louisville KY 40215-3101
Phone: (502) 363-0588
Fax: (502) 363-0972
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA851 Kentucky

Profile Details

NPI number 1578566600
LBN Legal business name Edds, Melissa Dawn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Feb 5th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578566600 NPPES
Kentucky Other 1299470001 PTAN
Kentucky MEDICAID 7100172620 PTAN

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