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NPI Code Detail

MEDICARE: MELISSA GAIL KILCREASE

MEDICARE:   MELISSA GAIL KILCREASE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1-101444AL

General Provider Information

NPI Number : 1023596871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA GAIL KILCREASE
Provider Business Mailing Address
First Line : 78 BRYAN LN
Second Line :
City : BREWTON
State : AL
Zip : 36426-3432
Country : US
Telephone Number : 251-363-0154
Fax Number :
Provider Business Practice Location Address
First Line : 174 HIGHWAY 113
Second Line :
City : FLOMATON
State : AL
Zip : 36441-4556
Country : US
Telephone Number : 251-296-2456
Fax Number : 251-296-2400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2018
Last Update Date : 03/07/2024

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Directions to “ MELISSA GAIL KILCREASE ” Practice Location

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