Provider Demographics
NPI:1447659685
Name:MERRITT, MELISSA ANN (APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:MERRITT
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 S FIRST ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4403
Mailing Address - Country:US
Mailing Address - Phone:573-356-8253
Mailing Address - Fax:660-956-4712
Practice Address - Street 1:300 W HUTCHINGS ST
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-2109
Practice Address - Country:US
Practice Address - Phone:515-462-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014024767363LF0000X
IAA144862363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5203994OtherCSA
IAA144862OtherARNP
MO1447659685Medicaid
MO2014024767OtherAPRN-FNP