Individual
MELINDA P GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3101 PARISA DR., PADUCAH, KY 42003
(270) 444-8477
(270) 444-8479
Mailing address
3101 PARISA DR., PADUCAH, KY 42003
(270) 444-8477
(270) 444-8479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA465
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680999
BCBS
KY
05
—
95003893
—
KY
01
—
P00883248
MEDICARE RAILROAD
KY
01
—
PA465
LICENSE
KY
Enumeration date
11/17/2005
Last updated
08/23/2018
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