Individual
MELISSA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6643 SHEPLEY DR, SAINT LOUIS, MO 63105-2354
(314) 935-6666
(314) 935-8515
Mailing address
6643 SHEPLEY DR, SAINT LOUIS, MO 63105-2354
Taxonomy
Speciality
Code
Description
License number
State
163WC1400X
College Health Registered Nurse
Primary
2010013258
MO
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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