Healthcare Provider Details

I. General information

NPI: 1144572447
Provider Name (Legal Business Name): MELISSA A MORRISSEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2012
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W 10TH ST
ROLLA MO
65401-2905
US

IV. Provider business mailing address

1050 W 10TH ST
ROLLA MO
65401-2905
US

V. Phone/Fax

Practice location:
  • Phone: 573-458-8899
  • Fax: 573-341-5611
Mailing address:
  • Phone: 573-458-8899
  • Fax: 573-341-5611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number2019017548
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: