Healthcare Provider Details

I. General information

NPI: 1265039309
Provider Name (Legal Business Name): MELISSA SIMPSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA GAIL DURHAM

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 W LOWRY LN
LEXINGTON KY
40503-3018
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 859-334-1550
  • Fax: 877-471-2996
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3014732
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: