Provider Demographics
NPI:1326213539
Name:SPANN, MELANIE JANE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:JANE
Last Name:SPANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 DUTCHMANS PKWY
Mailing Address - Street 2:SUITE 380
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3372
Mailing Address - Country:US
Mailing Address - Phone:502-894-9753
Mailing Address - Fax:502-371-0929
Practice Address - Street 1:1405 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3736
Practice Address - Country:US
Practice Address - Phone:812-283-0728
Practice Address - Fax:812-283-0792
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
KY0363237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter