Healthcare Provider Details

I. General information

NPI: 1902764145
Provider Name (Legal Business Name): KARINA LYNN MELVIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E MARKET ST STE 301
LOUISVILLE KY
40206-1874
US

IV. Provider business mailing address

108 GOODLOE AVE
BLOOMFIELD KY
40008-7123
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-3099
  • Fax: 502-629-3099
Mailing address:
  • Phone: 502-629-3099
  • Fax: 502-629-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number1119913
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: