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Melinda Mae Pezzi

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as MELINDA PEZZI.

Based on the most recent information from CMS, provider Melinda Mae Pezzi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1851042840
Provider Type
Individual
Full Name
Pezzi, Melinda Mae
Gender
Female

Sole Proprietor
No
Enumeration Date
1/12/2022
Last Updated
8/29/2022

Contact Information

Practice Location

1102 S Main St, London, KY 40741-1529

(606) 770-5121

(606) 770-5199

Mailing Location

1102 S Main St, London, KY 40741-1529

(606) 770-5121

(606) 770-5199

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 3017260 Kentucky

Provider Identifiers

ID	Description	Issuer
ID K361260	Description Other	Issuer INDIVIDUAL MEDICARE PTAN Kentucky

Melinda Mae Pezzi

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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