Doctor Name: | MRS. MELISSA ANN KENAMOND |
NPI Number: | 1144575051 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | COA. 13511-NP |
Business Practice Address: | 426 8th St Ste. 305 Glen Dale, WV - 260381451 |
Business Phone Number: | 3044835041 |
Business Fax Number: | 3048454586 |
Mailing Address: | 426 8th St, Ste. 305 GLEN DALE |
State: | WV |
Postal Code: | 260381451 |
Phone Number: | 3044835041 |
Fax Number: | 3048454586 |
NPI Enumeration Date: | 07/17/2012 |
NPI Last Update Date: | 07/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA. 13511-NP |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |