Basic Information
| Provider Information | |||||||||
| NPI: | 1326599911 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMSTEAD | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | ANNETTE | ||||||||
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| Credential: | DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5701 DELMAR BLVD | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631122617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3143677848 | ||||||||
| FaxNumber: | 3143672985 | ||||||||
| Practice Location | |||||||||
| Address1: | 49 N FLORISSANT RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | FERGUSON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631352312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146338921 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2016 | ||||||||
| LastUpdateDate: | 06/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 2015030349 | MO | N | Nursing Service Providers | Registered Nurse | 163W00000X | 041437555 | IL | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 209024969 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 2022012289 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.