Basic Information
| Provider Information | |||||||||
| NPI: | 1952395923 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MELANDER | ||||||||
| FirstName: | SHEILA | ||||||||
| MiddleName: | KAYE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 815 E PARRISH AVE | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | OWENSBORO | ||||||||
| State: | KY | ||||||||
| PostalCode: | 423033222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2709262998 | ||||||||
| FaxNumber: | 2709261181 | ||||||||
| Practice Location | |||||||||
| Address1: | 317 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WILMORE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403901323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8598580339 | ||||||||
| FaxNumber: | 8598580341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2005 | ||||||||
| LastUpdateDate: | 10/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN0000121082 | TN | N | Nursing Service Providers | Registered Nurse | 363LA2100X | 3223P | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | 28107289A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | 3003223 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 200393570 | 05 | IN | MEDICAID | 78007085 | 05 | KY | MEDICAID |