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General NPI Number Information
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NPI Number | 1669797924
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Entity Type | Individual
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Provider Name | MELISSA LOU ANDERSON M.A.-CCCA
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Gender | Female
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | BLANCHFIELD ARMY COMMUNITY HOSPITAL 650 JOEL DRIVE
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City | FORT CAMPBELL
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State | KY
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Zip | 42223
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Country | US
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Telephone | 270-798-4677
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Fax |
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Provider Business Mailing Address
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Address Line | 156 S DOSSETT DRIVE PO BOX 70643
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City | JOHNSON CITY
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State | TN
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Zip | 37614-1702
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Country | US
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Telephone | 423-439-4584
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Fax | 423-439-4607
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1601000500
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License Number State | MI
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