Black, Mellisa Dawn
Black, Mellisa Dawn is an individual health care provider with primary practice located at 1400 Us Highway 61 Ste 150 , Festus MO 63028-4141. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Black, Mellisa Dawn can be contacted via phone (636) 543-2230.Contact Information
Primary practice address
1400 Us Highway 61 Ste 150
Festus MO 63028-4141
Phone: (636) 543-2230
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 2023002795 | Missouri |
Profile Details
| NPI number | 1619673894 |
|---|---|
| LBN Legal business name | Black, Mellisa Dawn |
| Credentials | PMHNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 31st, 2023 |
| Last updated | Jan 31st, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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