MEDICARE: KARINA LYNN MELVIN RN

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	163WP0200X	Pediatric Registered Nurse	1119913	KY

General Provider Information

NPI Number	:	1902764145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARINA LYNN MELVIN RN

Provider Business Mailing Address
First Line	:	108 GOODLOE AVE
Second Line	:
City	:	BLOOMFIELD
State	:	KY
Zip	:	40008-7123
Country	:	US
Telephone Number	:	502-629-3099
Fax Number	:	502-629-3096

Provider Business Practice Location Address
First Line	:	1050 E MARKET ST STE 301
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40206-1874
Country	:	US
Telephone Number	:	502-629-3099
Fax Number	:	502-629-3099

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

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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