Individual
MS. MELINDA SUSAN WAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
199 EAST 4TH STREET, BUILDING 2081, SUITE H., FORT LEONARD WOOD, MO 65473-8952
(573) 329-1901
Mailing address
126 MISSOURI AVE., MEDDAC , CHRC , BOX 1229, FORT LEONARD WOOD, MO 65473-8952
(573) 329-1901
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2000154973
MO
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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