| Melanated Healthcare Inc | |
|
10300 Brookridge Village Blvd Ste 203 Louisville KY 40291-4474 | |
| (502) 600-1704 | |
| (844) 464-0789 |
| Full Name | Melanated Healthcare Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 10300 Brookridge Village Blvd Ste 203, Louisville, Kentucky |
| Authorized Official Name and Position | Lecresha Sewell (OWNER) |
| Authorized Official Contact | 2707695963 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Melanated Healthcare Inc 10300 Brookridge Village Blvd Ste 203 Louisville KY 40291-4474 Ph: (502) 600-1704 | Melanated Healthcare Inc 10300 Brookridge Village Blvd Ste 203 Louisville KY 40291-4474 Ph: (502) 600-1704 |
| NPI Number | 1184320236 |
|---|---|
| Provider Enumeration Date | 01/31/2023 |
| Last Update Date | 04/21/2023 |
| Medicare PECOS PAC ID | 9436518503 |
|---|---|
| Medicare Enrollment ID | O20230707000817 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184320236 | NPI | - | NPPES |
| 1093107781 | Other | KY | NURSE PRACTITIONER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LW0102X | Nurse Practitioner - Women's Health | (* (Not Available)) | Secondary |
| Provider Name | Tanya E Franklin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114060621 PECOS PAC ID: 0042383077 Enrollment ID: I20080723000696 |
| Provider Name | Lecresha Y Sewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093107781 PECOS PAC ID: 6002133006 Enrollment ID: I20150401001835 |
| Provider Name | Angelina M Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497005573 PECOS PAC ID: 2567753288 Enrollment ID: I20160816001732 |
| Provider Name | Whitney Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861908949 PECOS PAC ID: 9133488927 Enrollment ID: I20180124002794 |
| Provider Name | Ana Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851724777 PECOS PAC ID: 7315275310 Enrollment ID: I20190829001600 |
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