Provider Demographics
NPI:1669922068
Name:HUFF, MELANIE (ANP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HUFF
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:STE. 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:314-996-7960
Mailing Address - Fax:314-989-0235
Practice Address - Street 1:3009 N BALLAS RD
Practice Address - Street 2:STE 207B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2322
Practice Address - Country:US
Practice Address - Phone:314-996-7960
Practice Address - Fax:314-989-0235
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2016036661363LA2200X
MO2010003376163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse