=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265119994
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELANIE KATHERINE CROW PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/04/2023
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 625 S NEW BALLAS RD STE 2030
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63141-8253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-251-1700
-----------------------------------------------------
Fax | 314-251-1701
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 625 S NEW BALLAS RD STE 2030
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63141-8253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-251-1700
-----------------------------------------------------
Fax | 314-251-1701
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 085.009685
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 2025035385
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------