Provider Demographics
NPI:1053605774
Name:PRESLEY, MELODY A (APRN)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:A
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40071-8616
Mailing Address - Country:US
Mailing Address - Phone:502-477-1955
Mailing Address - Fax:502-477-5524
Practice Address - Street 1:83 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40071-8616
Practice Address - Country:US
Practice Address - Phone:502-477-1955
Practice Address - Fax:502-477-5524
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006932363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care