Provider Demographics
NPI:1629695770
Name:DODD, MELISSA A (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:DODD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:DAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 S 8TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2404
Mailing Address - Country:US
Mailing Address - Phone:270-753-4616
Mailing Address - Fax:
Practice Address - Street 1:305 S 8TH ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2404
Practice Address - Country:US
Practice Address - Phone:270-753-4616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-05
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily