Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 2012014711 | MO |
NPI | 1275774887 |
---|---|
Provider Name | Dr. Erica Lynn Melrose |
First Address | Springfield, MO 65804-2257 |
Second Address | Springfield, MO 65804-2257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2009 |
Last Update Date | 27/09/2018 |