Healthcare Provider Details

I. General information

NPI: 1316313059
Provider Name (Legal Business Name): MELANIE LINDO LAPINSKI AGP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 N 4TH ST
SAINT CHARLES MO
63301-2053
US

IV. Provider business mailing address

808 N 4TH ST
SAINT CHARLES MO
63301-2053
US

V. Phone/Fax

Practice location:
  • Phone: 323-496-1478
  • Fax:
Mailing address:
  • Phone: 323-496-1478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAG0815073
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAG0815073
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAG0815073
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: