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Individual

MRS. ALYSSA M MELLENCAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3105 N BEND RD, HEBRON, KY 41048-8523
(615) 425-4201
Mailing address
2620 ELM HILL PIKE, NASHVILLE, TN 37214-3108

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0031263
OH
363LF0000X
Family Nurse Practitioner
Primary
3017660
KY
363LF0000X
Family Nurse Practitioner
71007434A
IN

Other

Enumeration date
07/31/2017
Last updated
05/18/2022
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