Individual
MELISSA ANN JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1653
(270) 825-5100
Mailing address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1653
(270) 825-5100
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA022
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000346596
BCBS PROVIDER NUMBER
KY
Enumeration date
01/22/2008
Last updated
01/22/2008
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