Provider Demographics
NPI:1346538204
Name:SOPER, MELISSA KATHRYN (APRN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:KATHRYN
Last Name:SOPER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:ALBERT B. CHANDLER MEDICAL CENTER, MN-564
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-5049
Mailing Address - Fax:859-323-0232
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:ALBERT B. CHANDLER MEDICAL CENTER, MN-564
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-5049
Practice Address - Fax:859-323-0232
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1108590163W00000X
KY3006995363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse