Individual
MRS. MELISSA BLAIR WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2616 LEGENDS WAY, CRESTVIEW HILLS, KY 41017
(859) 331-3100
Mailing address
2616 LEGENDS WAY, CRESTVIEW HILLS, KY 41017-2418
(859) 331-3100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008619
GA
363A00000X
Physician Assistant
10001781A
IN
363A00000X
Physician Assistant
Primary
PA1130
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1081470
NCCPA
—
Enumeration date
07/25/2008
Last updated
05/23/2018
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