Melton, Connie Ann

Melton, Connie Ann is an individual health care provider with primary practice located at 1025 S 2Nd St , Louisville KY 40203-2823. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Melton, Connie Ann can be contacted via phone (502) 584-2473.

Contact Information

Primary practice address
1025 S 2Nd St Louisville KY 40203-2823
Phone: (502) 584-2473
Fax: (502) 657-0228
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA152 Kentucky

Profile Details

NPI number 1942245253
LBN Legal business name Melton, Connie Ann
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942245253 NPPES
Kentucky MEDICAID 50006904

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