Provider Demographics
NPI:1831791284
Name:DENNING, MERISSA DANIELLE (DPT)
Entity type:Individual
Prefix:DR
First Name:MERISSA
Middle Name:DANIELLE
Last Name:DENNING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:EMINENCE
Mailing Address - State:MO
Mailing Address - Zip Code:65466-0583
Mailing Address - Country:US
Mailing Address - Phone:417-770-1615
Mailing Address - Fax:
Practice Address - Street 1:18346 JF NORTON PARKWAY
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MO
Practice Address - Zip Code:65588-6558
Practice Address - Country:US
Practice Address - Phone:573-226-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020039528225100000X
KS11-06639208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation