Healthcare Provider Details

I. General information

NPI: 1427655612
Provider Name (Legal Business Name): MELOVE JO CASEY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 CRUCIFER RD
HURON TN
38345-9519
US

IV. Provider business mailing address

PO BOX 695
LEXINGTON TN
38351-0695
US

V. Phone/Fax

Practice location:
  • Phone: 731-614-2307
  • Fax: 308-888-6738
Mailing address:
  • Phone: 731-614-2307
  • Fax: 308-888-6738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28318
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28318
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: