Basic Information
| Provider Information | |||||||||
| NPI: | 1992064463 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RHODES | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | GAY | ||||||||
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| Credential: | F.N.P.-B.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 760 PLANTATION BLVD | ||||||||
| Address2: | |||||||||
| City: | SIKESTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 638015736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5734710800 | ||||||||
| FaxNumber: | 5734812799 | ||||||||
| Practice Location | |||||||||
| Address1: | 760 PLANTATION BLVD | ||||||||
| Address2: | |||||||||
| City: | SIKESTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 638015736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5734710800 | ||||||||
| FaxNumber: | 5734812799 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2012 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 3017827 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 2012010244 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.