Provider Demographics
NPI:1225258130
Name:CHENG, MELISSA BETH (MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:BETH
Last Name:CHENG
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:WHITLEY CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42653-0250
Mailing Address - Country:US
Mailing Address - Phone:606-376-7212
Mailing Address - Fax:606-687-3151
Practice Address - Street 1:71 MEDICAL LN
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653-4216
Practice Address - Country:US
Practice Address - Phone:606-376-7212
Practice Address - Fax:606-687-3151
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002366A363LF0000X
KY5510P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily