Individual
MELISSA BOUCHER DENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 PROFESSIONAL PARK DR, GLASGOW, KY 42141-3487
(270) 651-9696
(270) 651-0385
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 864-1472
(270) 864-1693
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
KY28593
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64285935
—
KY
Enumeration date
11/22/2005
Last updated
05/05/2014
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