MEDICARE: MELANIE ELISE HOEFERLIN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2022007579	MO
2	363LG0600X	Gerontology Nurse Practitioner	2022007579	MO

General Provider Information

NPI Number	:	1588374862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE ELISE HOEFERLIN NP

Provider Business Mailing Address
First Line	:	4590 S LINDBERGH BLVD STE 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1839
Country	:	US
Telephone Number	:	314-270-9494
Fax Number	:	314-270-9495

Provider Business Practice Location Address
First Line	:	4590 S LINDBERGH BLVD STE 101
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1839
Country	:	US
Telephone Number	:	314-270-9494
Fax Number	:	314-270-9495

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2022
Last Update Date	:	01/06/2026

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