| Doctor Name: | MELISSA MARIE FARRIS |
| NPI Number: | 1205259942 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 2014000691 |
| Business Practice Address: | 5325 Faraon St. St. Joseph, MO - 645063488 |
| Business Phone Number: | 8162716122 |
| Business Fax Number: | 8162716019 |
| Mailing Address: | 5325 Faraon St., ST. JOSEPH |
| State: | MO |
| Postal Code: | 645063488 |
| Phone Number: | 8162716122 |
| Fax Number: | 8162716019 |
| NPI Enumeration Date: | 01/31/2014 |
| NPI Last Update Date: | 01/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2014000691 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |