Healthcare Provider Details

I. General information

NPI: 1487484176
Provider Name (Legal Business Name): MELICIA HUNT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 S BRENTWOOD BLVD STE 1120
SAINT LOUIS MO
63117-1211
US

IV. Provider business mailing address

2133 VADALABENE DR STE 5B
MARYVILLE IL
62062-5839
US

V. Phone/Fax

Practice location:
  • Phone: 314-617-2000
  • Fax:
Mailing address:
  • Phone: 618-288-7605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209029638
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2024001079
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: