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Individual

MS. MELISSA MARIE HALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
300 CARRERA DR, LONDON, KY 40741-6303
(606) 657-2079
(818) 337-3798
Mailing address
87 WILDCAT LN, CORBIN, KY 40701-8950
(606) 261-5344
(818) 337-3798

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1567
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100285080
KY
01
P01439783
RR MEDICARE
KY
01
PA1567
MEDICAL LICENSE
KY
Enumeration date
06/30/2009
Last updated
05/12/2025
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