MS. MELISSA SUE WAGNER (NPI# 1366763708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366763708 |
| Entity Type | Individual |
| Full Name | MS. MELISSA SUE WAGNER |
| Credential | ACNP |
| Practice Address |
400 S Kingshighway Blvd Saint Louis MO 63110-1014 |
| Mailing Address |
660 S Euclid Ave C B 8072 Saint Louis MO 63110-1010 |
| Practice Telephone | 3143629123 |
| Practice Fax Number | 3147473388 |
| Mailing Telephone | 3313629123 |
| Mailing Fax Number | 3147473338 |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2015-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
2010012196 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932664075 | Melissa R Wagner | Counselor | 1824 Ratchford Dr, Dallas, NC 28034-7528 | 2019-02-03 |
| 1417598491 | Melissa Anne Wagner | Nurse Practitioner | 2701 Blair Mill Rd, Suite 20, Willow Grove, PA 19090 | 2019-10-01 |
| 1306408109 | Melissa Anne Wagner | Registered Nurse | 5500 Armstrong Rd, Battle Creek, MI 49037-7314 | 2019-07-01 |
| 1073006037 | Melissa Marie Wagner | Speech-Language Pathologist | 8848 Red Oak Blvd Ste Aa, Charlotte, NC 28217-5595 | 2018-06-13 |
| 1275077265 | Melissa Hart Wagner | Occupational Therapist | 120 Cavette Hill Ln, Rehab Department, Knoxville, TN 37934-6673 | 2016-12-09 |
| 1356891105 | Melissa Wagner | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2016-10-05 |
| 1174992382 | Melissa Dalton Wagner | Nurse Practitioner | 64 Kirk Plz, Inez, KY 41224 | 2015-09-17 |
| 1366843229 | Melissa Wagner | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2014-09-10 |
| 1063820710 | Melissa Wagner | Radiologic Technologist | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2014-07-25 |
| 1639338478 | Melissa A Wagner | Massage Therapist | 207 W Summit St, Souderton, PA 18964-2054 | 2008-06-06 |
| Street Address |
400 S KINGSHIGHWAY BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063407963 | Joseph H Gatewood | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2005-09-16 |
| 1912524117 | Andrew Lamp | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2020-07-03 |
| 1013565308 | Kelley Dufour | Physician Assistant | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2019-08-29 |
| 1851945869 | Hannah Margaret Pfeifer | Nurse Practitioner | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2019-07-29 |
| 1922669167 | Nicholas William Karlow | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2019-06-27 |
| 1487113999 | Sarah Marie Halliday | Nurse Practitioner | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2019-03-14 |
| 1750849873 | Allison Claire French | Physician Assistant | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2019-03-07 |
| 1124584651 | Evelyn Kay Scrivner | Nurse Practitioner | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2019-02-20 |
| 1578027918 | Richard Austin Hazlett | Physician Assistant | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2019-01-30 |
| 1720579063 | Darcey Alana Elliott | Physician Assistant | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2018-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841897394 | Lara Kang | Nurse Practitioner | 7354 S Yorkshire Dr, Saint Louis, MO 63123-2111 | 2020-10-07 |
| 1265064703 | Kelsey Elizabeth Ortmann | Nurse Practitioner | 4962 Tyrolean Ave, Saint Louis, MO 63109-3760 | 2020-02-11 |
| 1427606250 | Erin Kate Adlon | Nurse Practitioner | 1 Barnes Jewish Hospital Plz # 10400, Saint Louis, MO 63110-1003 | 2019-08-26 |
| 1164993622 | Alexandra Nicole Shero | Nurse Practitioner | 660 South Euclid Avenue #8054, Saint Louis, MO 63110-1010 | 2018-12-10 |
| 1932647302 | Lorena Zerwig | Nurse Practitioner | 3219 Portis Ave, Saint Louis, MO 63116-2025 | 2017-02-06 |
| 1780011023 | Elvisa Kurtovic | Nurse Practitioner | 4921 Parkview Pl Fl 6, 6 Fl, Saint Louis, MO 63110-1032 | 2013-10-01 |
| 1275863441 | Katheryne Tifuh Amba | Nurse Practitioner | 999 Executive Parkway Dr Ste 210, Saint Louis, MO 63141-6336 | 2010-01-11 |
| 1346579281 | Advanced Icu Care | Nurse Practitioner | 999 Executive Parkway Dr, Ste 210, Saint Louis, MO 63141-6336 | 2009-12-23 |
| 1235135237 | Loretta Jane Colvin | Nurse Practitioner | 2531 S Big Bend Blvd, Saint Louis, MO 63143-2112 | 2005-06-23 |
| 1295335966 | Tracy Novak | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-10-30 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
Please comment or provide details below to improve the information on MS. MELISSA SUE WAGNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.