Provider Demographics
NPI:1659681799
Name:NASH, MELODY R (ARNP)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:R
Last Name:NASH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 ANDREA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-5853
Mailing Address - Country:US
Mailing Address - Phone:615-515-1900
Mailing Address - Fax:615-292-4633
Practice Address - Street 1:1325 ANDREA ST STE 100
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-5853
Practice Address - Country:US
Practice Address - Phone:615-515-1900
Practice Address - Fax:615-292-4633
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006652363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP400030561Medicaid
KYP400030561Medicaid