Provider Demographics
NPI:1356896518
Name:BARNETT, MELISSA (PMHNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BARNETT
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:KY
Mailing Address - Zip Code:40336-1118
Mailing Address - Country:US
Mailing Address - Phone:606-717-1024
Mailing Address - Fax:606-717-1048
Practice Address - Street 1:110 RIVER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-1118
Practice Address - Country:US
Practice Address - Phone:606-717-1024
Practice Address - Fax:606-717-1048
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1114322363L00000X
KY3010499363L00000X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily