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General NPI Number Information
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NPI Number | 1578586491
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Entity Type | Individual
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Provider Name | MELISSA BRADLO WHNP
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 3023 N BALLAS RD DIV OBGYN GYNECOLOGIC ONCOLOGY, STE 450D
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2330
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Country | US
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Telephone | 314-362-3181
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Fax | 314-362-2893
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Provider Business Mailing Address
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Address Line | PO BOX 7412011
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City | CHICAGO
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State | IL
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Zip | 60674-2011
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Country | US
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Telephone | 314-362-3181
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Fax | 314-362-2893
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 133637
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License Number State | MO
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