Basic Information
| Provider Information | |||||||||
| NPI: | 1003151770 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEGNER | ||||||||
| FirstName: | MELINDA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3445 SOUTH 291 HWY | ||||||||
| Address2: | STE 300 | ||||||||
| City: | INDEPENDENCE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167951968 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3445 SOUTH 291 HWY | ||||||||
| Address2: | STE 300 | ||||||||
| City: | INDEPENDENCE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167951968 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2012 | ||||||||
| LastUpdateDate: | 12/06/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 2001003796 | MO | Y | Nursing Service Providers | Registered Nurse | 163WA0400X | 2001003796 | MO | N | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) | 163WA2000X | 2001003796 | MO | N | Nursing Service Providers | Registered Nurse | Administrator | 163WC1600X | 2001003796 | MO | N | Nursing Service Providers | Registered Nurse | Continuing Education/Staff Development | 163WI0600X | 2001003796 | MO | N | Nursing Service Providers | Registered Nurse | Infection Control |
No ID Information.