Basic Information
Provider Information
NPI: 1720054240
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ISBELL
FirstName: MELANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 310 N L ROGERS WELLS BLVD
Address2:  
City: GLASGOW
State: KY
PostalCode: 421411300
CountryCode: US
TelephoneNumber: 2706511111
FaxNumber: 2706595608
Practice Location
Address1: 310 N L ROGERS WELLS BLVD
Address2:  
City: GLASGOW
State: KY
PostalCode: 421411300
CountryCode: US
TelephoneNumber: 2706511111
FaxNumber: 2706595608
Other Information
ProviderEnumerationDate: 02/24/2006
LastUpdateDate: 04/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X1099054KYN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X3004674KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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