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Individual

MS. MELISSA DIANE GRISAFFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
2115 S FREMONT AVE, SPRINGFIELD, MO 65804-2239
(417) 820-5200
(417) 820-5220
Mailing address
PO BOX 251420, LITTLE ROCK, AR 72225-1420
(501) 686-8000

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
2014022681
MO
363LA2100X
Acute Care Nurse Practitioner
A004218
AR
363LA2200X
Adult Health Nurse Practitioner
2014022681
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
A004218
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1154724144
MO
Enumeration date
10/03/2014
Last updated
01/06/2022
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