Individual
MELISSA IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1475 KISKER RD, SAINT CHARLES, MO 63304-8781
(636) 498-7405
Mailing address
1475 KISKER RD, SAINT CHARLES, MO 63304-8781
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015034686
MO
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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