Individual
MRS. MELISSA P PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 LEMAY FERRY RD, SAINT LOUIS, MO 63125-3900
(314) 543-5294
(314) 892-1658
Mailing address
2900 LEMAY FERRY RD, SAINT LOUIS, MO 63125-3900
(314) 543-5294
(314) 892-1658
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11042
MN
363A00000X
Physician Assistant
Primary
2012037436
MO
363A00000X
Physician Assistant
WA PA 10004933
WA
Other
Enumeration date
08/31/2006
Last updated
03/15/2017
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