Provider Demographics
NPI:1760544928
Name:PAFFORD, MELENEY A (APRN)
Entity type:Individual
Prefix:
First Name:MELENEY
Middle Name:A
Last Name:PAFFORD
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 1:1000 BRECKENRIDGE ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-0839
Mailing Address - Country:US
Mailing Address - Phone:270-691-5900
Mailing Address - Fax:270-852-4924
Practice Address - Street 1:1000 BRECKENRIDGE ST
Practice Address - Street 2:SUITE 303
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-0839
Practice Address - Country:US
Practice Address - Phone:270-691-5900
Practice Address - Fax:270-852-4924
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12404363LP0808X
KY3005526363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100046300Medicaid
IN200939370Medicaid
Q77587Medicare UPIN
KY7100046300Medicaid