Individual
MRS. MELISSA L RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017
(636) 735-4268
Mailing address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(636) 735-4268
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
121267
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932322559
—
MO
05
—
ENROLLED
—
IL
Enumeration date
04/11/2007
Last updated
05/24/2019
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