Individual
MELISSA D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1965 S FREMONT AVE STE 370, SPRINGFIELD, MO 65804-2284
(417) 820-0300
Mailing address
1965 S FREMONT AVE STE 370, SPRINGFIELD, MO 65804-2284
(417) 820-0300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2017033363
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710231139
—
MO
Enumeration date
11/07/2012
Last updated
04/20/2021
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