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General NPI Number Information
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NPI Number | 1053208868
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Entity Type | Individual
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Provider Name | MELISSA VICKERY APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1025 S MAIN ST
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City | MONTICELLO
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State | KY
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Zip | 42633-2762
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Country | US
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Telephone | 606-340-8870
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Fax | 606-340-9828
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Provider Business Mailing Address
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Address Line | PO BOX 1080
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City | BURKESVILLE
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State | KY
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Zip | 42717-1080
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Country | US
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Telephone | 270-858-6655
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Fax | 270-858-4027
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4042689
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License Number State | KY
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