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General NPI Number Information
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NPI Number | 1922992858
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Entity Type | Individual
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Provider Name | DANIELLE PAIGE MELNEK NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 200 ADMIRAL TROST RD STE 1A
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City | COLUMBIA
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State | IL
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Zip | 62236-2164
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Country | US
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Telephone | 618-281-7373
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 959203
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9203
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Country | US
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Telephone | 618-281-7373
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Fax | 618-281-6463
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209032589
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 041536934
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License Number State | IL
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