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NPI Code Detail

MEDICARE: MRS. MELANIE NICOLE PILKENTON PA-C

MEDICARE: MRS. MELANIE NICOLE PILKENTON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant2004007502MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1656580OTHERMOHEALTHLINK

General Provider Information

NPI Number : 1245238401
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELANIE NICOLE PILKENTON PA-C
Provider Business Mailing Address
First Line : PO BOX 955534
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63195-5534
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1475 KISKER RD STE 200
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63304-8788
Country : US
Telephone Number : 636-498-5810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 01/12/2021

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Directions to “ MRS. MELANIE NICOLE PILKENTON PA-C” Practice Location

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