Provider Demographics
NPI:1952885998
Name:DRURY, MELANIE (MSN APRN FNP SANE-A)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:DRURY
Suffix:
Gender:F
Credentials:MSN APRN FNP SANE-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37170
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1213
Mailing Address - Country:US
Mailing Address - Phone:888-488-8289
Mailing Address - Fax:833-449-5150
Practice Address - Street 1:10203 WOOD VIOLET CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40228-1944
Practice Address - Country:US
Practice Address - Phone:502-428-9573
Practice Address - Fax:833-449-5150
Is Sole Proprietor?:No
Enumeration Date:2018-09-15
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCS1936500272OtherCARESOURCE
KYPDZ000000285303OtherAETNA BETTER HEALTH
KY7100592200Medicaid
KY8002467OtherGALAXY