Individual
MELISSA KATHLEEN NIEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3268 GWENGREEN DR., BRIDGETON, MO 63044
(314) 392-7217
Mailing address
3268 GWENGREEN DR, BRIDGETON, MO 63044-3311
(314) 392-7217
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
163W00000X
MO
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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