Healthcare Provider Details

I. General information

NPI: 1447659685
Provider Name (Legal Business Name): MELISSA ANN MERRITT APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 08/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HUTCHINGS ST
WINTERSET IA
50273-2109
US

IV. Provider business mailing address

1811 S FIRST ST
KIRKSVILLE MO
63501-4403
US

V. Phone/Fax

Practice location:
  • Phone: 515-462-5115
  • Fax:
Mailing address:
  • Phone: 573-356-8253
  • Fax: 660-956-4712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA144862
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2014024767
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: