Healthcare Provider Details

I. General information

NPI: 1285149864
Provider Name (Legal Business Name): KATHRYN LEIGH MELVIN CNM, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S FLOYD ST STE 500
LOUISVILLE KY
40202-1837
US

IV. Provider business mailing address

PO BOX 776351
CHICAGO IL
60677-6351
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-1515
  • Fax:
Mailing address:
  • Phone: 502-559-9425
  • Fax: 502-272-5339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number3012739
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: