Healthcare Provider Details

I. General information

NPI: 1952395923
Provider Name (Legal Business Name): SHEILA DRAKE MELANDER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA KAYE MELANDER APRN

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E MAIN ST
WILMORE KY
40390-1323
US

IV. Provider business mailing address

815 E PARRISH AVE SUITE 330
OWENSBORO KY
42303-3222
US

V. Phone/Fax

Practice location:
  • Phone: 859-858-0339
  • Fax: 859-858-0341
Mailing address:
  • Phone: 270-926-2998
  • Fax: 270-926-1181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000121082
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3223P
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number28107289A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3003223
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: