Basic Information
| Provider Information | |||||||||
| NPI: | 1518303957 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRANDS | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | APRN-NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 21ST AVE N | ||||||||
| Address2: | STE 100 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372031821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153295144 | ||||||||
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| Practice Location | |||||||||
| Address1: | 201 ABRAHAM FLEXNER WAY | ||||||||
| Address2: | SUITE 1101 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402023841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025811951 | ||||||||
| FaxNumber: | 5025405137 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2013 | ||||||||
| LastUpdateDate: | 08/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 1115234 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 25952 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 3008051 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 201175500 | 05 | IN | MEDICAID | 7100244860 | 05 | KY | MEDICAID |