Provider Demographics
NPI:1578756821
Name:CHESNUT, MELANIE LIND (APRN)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:LIND
Last Name:CHESNUT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:LIND
Other - Last Name:CHESNUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:80 HOSPITAL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-7363
Mailing Address - Country:US
Mailing Address - Phone:606-545-4460
Mailing Address - Fax:065-454-4469
Practice Address - Street 1:80 HOSPITAL DR STE 2
Practice Address - Street 2:
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-7363
Practice Address - Country:US
Practice Address - Phone:606-545-4460
Practice Address - Fax:606-545-4469
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005280363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100030780Medicaid
KY7100030780Medicaid