Individual
MELISSA HARMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
215 E MAIN ST, PROVIDENCE, KY 42450-1261
(270) 667-7017
Mailing address
215 E MAIN ST, PROVIDENCE, KY 42450-1261
(270) 667-7017
(855) 632-8329
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1093872
KY
363L00000X
Nurse Practitioner
71007737A
IN
363LF0000X
Family Nurse Practitioner
Primary
3011977
KY
363LF0000X
Family Nurse Practitioner
71007737A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14173317
CAQH
—
Enumeration date
01/02/2018
Last updated
04/06/2023
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