Doctor Name: | MELISSA KAYE WARMACK |
NPI Number: | 1144614488 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 2015008447 |
Business Practice Address: | 1 Hals Plaza Piedmont, MO - 63957 |
Business Phone Number: | 5739444088 |
Business Fax Number: | |
Mailing Address: | Po Box 408, GREENVILLE |
State: | MO |
Postal Code: | 639440408 |
Phone Number: | 5739444088 |
Fax Number: | |
NPI Enumeration Date: | 03/25/2015 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2015008447 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |