MEDICARE: MRS. MELISSA A GROVES APRN

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
1	363LF0000X	Family Nurse Practitioner	3007377	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3007377	OTHER	KY	APRN LIC
3	193400000X	OTHER	KY	TAXONOMY GROUP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000782080	OTHER	KY	ANTHEM

General Provider Information

NPI Number	:	1427320811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA A GROVES APRN

Provider Business Mailing Address
First Line	:	2341 NEW HOLT RD
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-7404
Country	:	US
Telephone Number	:	270-408-9355
Fax Number	:	270-441-9361

Provider Business Practice Location Address
First Line	:	2341 NEW HOLT RD
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-7404
Country	:	US
Telephone Number	:	270-408-9355
Fax Number	:	270-441-9361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2012
Last Update Date	:	02/05/2026

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