| Doctor Name: | MS. MELANIE V MAZE |
| NPI Number: | 1255587127 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP, BC |
| License Number: | 080039 |
| Business Practice Address: | 400 Medical Plaza Suite 100 Lake Saint Louis, MO - 633671395 |
| Business Phone Number: | 6366398600 |
| Business Fax Number: | 6366398676 |
| Mailing Address: | 500 Medical Drive, WENTZVILLE |
| State: | MO |
| Postal Code: | 63385 |
| Phone Number: | 6363271202 |
| Fax Number: | 3633271222 |
| NPI Enumeration Date: | 08/12/2008 |
| NPI Last Update Date: | 09/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 080039 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |