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NPI Code Detail

MEDICARE: MRS. MELISSA QUINN ARNP

MEDICARE: MRS. MELISSA QUINN ARNP
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
1363L00000XNurse Practitioner1078864KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13003997OTHERKYSTATE LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235282740
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA QUINN ARNP
Provider Business Mailing Address
First Line : PO BOX 776351
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6351
Country : US
Telephone Number : 502-588-9490
Fax Number : 502-272-5116
Provider Business Practice Location Address
First Line : 3999 DUTCHMANS LN STE 7B
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-4742
Country : US
Telephone Number : 502-896-4711
Fax Number : 502-896-4791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 05/17/2022

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