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General NPI Number Information
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NPI Number | 1265849699
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Entity Type | Individual
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Provider Name | MELISSA KAYE WAFFORD APRN
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Gender | Female
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 6425 DIXIE HWY
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City | FLORENCE
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State | KY
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Zip | 41042-2101
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Country | US
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Telephone | 859-282-0431
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Fax | 859-282-1482
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Provider Business Mailing Address
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Address Line | 6425 DIXIE HWY
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City | FLORENCE
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State | KY
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Zip | 41042-2101
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Country | US
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Telephone | 859-282-0431
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Fax | 859-282-1482
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3009955
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | COA.16268-NP
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN-306449-1
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License Number State | OH
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