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Individual

MELODY KAY TREVATHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNNP

Contact information

Practice address
2122 MANCHESTER EXPY, COLUMBUS, GA 31904-6878
(706) 320-2773
(706) 596-4226
Mailing address
2300 MANCHESTER EXPY STE 2001A, COLUMBUS, GA 31904-6802
(706) 320-3126
(706) 320-3054

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
RN082035
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
168374
AL
05
690662130B
GA
Enumeration date
09/18/2008
Last updated
08/07/2024
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