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Individual

MELISSA ANN HINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4783

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010495
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100441280
KY
01
K209811
MEDICARE
KY
Enumeration date
09/03/2016
Last updated
08/07/2023
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