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Individual
MELBA MECHELLE MASSIE
Active
Individual
MELBA MECHELLE MASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA625
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000608782
ANTHEM BCBS
KY
01
—
000000609841
ANTHEM BCBS
KY
05
—
95006086
—
KY
Enumeration date
07/06/2006
Last updated
09/06/2023
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