Provider Demographics
NPI:1619214913
Name:DAY, MELISSA F (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:F
Last Name:DAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 METKER TRL
Mailing Address - Street 2:STE A
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-1049
Mailing Address - Country:US
Mailing Address - Phone:606-365-8338
Mailing Address - Fax:606-365-8142
Practice Address - Street 1:107 METKER TRL
Practice Address - Street 2:STE A
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-1049
Practice Address - Country:US
Practice Address - Phone:606-365-8338
Practice Address - Fax:606-365-8142
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA1781363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK075900Medicare PIN