Individual ProviderMelissa ColemanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3165 S 2nd St, Louisville, KY 40208-1446(502) 309-4104PECOS EnrollmentBased on the most recent information from CMS, provider Melissa Coleman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1215679345Provider TypeIndividualFull NameColeman, MelissaCredentialAPRNGenderFemaleSole ProprietorNoEnumeration Date4/9/2022Last Updated4/9/2022Contact InformationPractice LocationPractice Address3165 S 2nd St, Louisville, KY 40208-1446Phone(502) 309-4104FaxUnlisted FaxMailing LocationMailing Address3135 Commerce Center Pl, Louisville, KY 40211-1975Phone(502) 309-4104FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense3017305Kentucky