Individual
MELINDA MAE PEZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 S MAIN ST, LONDON, KY 40741-1529
(606) 770-5121
(606) 770-5199
Mailing address
1102 S MAIN ST, LONDON, KY 40741-1529
(606) 770-5121
(606) 770-5199
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3017260
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K361260
INDIVIDUAL MEDICARE PTAN
KY
Enumeration date
01/12/2022
Last updated
08/29/2022
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