MEDICARE: MELANIE JANE SPANN

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
1	231H00000X	Audiologist
2	237600000X	Audiologist-Hearing Aid Fitter	0363	KY

General Provider Information

NPI Number	:	1326213539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE JANE SPANN

Provider Business Mailing Address
First Line	:	6420 DUTCHMANS PKWY
Second Line	:	SUITE 380
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3372
Country	:	US
Telephone Number	:	502-894-9753
Fax Number	:	502-371-0929

Provider Business Practice Location Address
First Line	:	1405 SPRING ST
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-3736
Country	:	US
Telephone Number	:	812-283-0728
Fax Number	:	812-283-0792

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	12/03/2009

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Directions to “ MELANIE JANE SPANN ” Practice Location

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