Healthcare Provider Details

I. General information

NPI: 1689900896
Provider Name (Legal Business Name): MELISSA GARLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2009
Last Update Date: 10/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5448 N US HIGHWAY 25E
GRAY KY
40734-6582
US

IV. Provider business mailing address

641 MANCHESTER ST APT. 7
BARBOURVILLE KY
40906-1758
US

V. Phone/Fax

Practice location:
  • Phone: 606-546-3152
  • Fax: 606-546-5057
Mailing address:
  • Phone: 606-546-3152
  • Fax: 606-546-5057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: