Healthcare Provider Details

I. General information

NPI: 1326858457
Provider Name (Legal Business Name): MELISSA ABERNATHY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 OLD LAGRANGE RD
CRESTWOOD KY
40014-8883
US

IV. Provider business mailing address

6120 OLD LAGRANGE RD
CRESTWOOD KY
40014-8883
US

V. Phone/Fax

Practice location:
  • Phone: 502-994-4354
  • Fax:
Mailing address:
  • Phone: 502-994-4354
  • Fax: 502-713-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number4050659
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: