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NPI Code Detail

MEDICARE: VICTORIA JADE MCMINN-MELTON MSW

MEDICARE: VICTORIA JADE MCMINN-MELTON MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1225545403
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA JADE MCMINN-MELTON MSW
Provider Business Mailing Address
First Line : 44 VANTAGE WAY STE 400
Second Line :
City : NASHVILLE
State : TN
Zip : 37228-1551
Country : US
Telephone Number : 615-463-6664
Fax Number :
Provider Business Practice Location Address
First Line : 584 CONGRESS PKWY S
Second Line :
City : ATHENS
State : TN
Zip : 37303-2258
Country : US
Telephone Number : 423-507-0887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2018
Last Update Date : 01/07/2019

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