Individual
MELISSA DAWN EDDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4402 CHURCHMAN AVE STE 300, LOUISVILLE, KY 40215-3101
(502) 363-0588
(502) 363-0972
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
(502) 587-4784
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA851
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1299470001
PTAN
KY
05
—
7100172620
—
KY
Enumeration date
05/23/2005
Last updated
02/05/2020
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