Individual
STACEY MELLIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4130 LINDELL BLVD, SAINT LOUIS, MO 63108-2914
(314) 535-5600
Mailing address
2730 SEDAN DR, SAINT LOUIS, MO 63125-4054
(314) 249-6265
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2016009690
MO
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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