Provider Demographics
NPI:1528482759
Name:WREN, MELISSA (NP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WREN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 SE BLUE PKWY
Mailing Address - Street 2:SUITE 270A
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-1041
Mailing Address - Country:US
Mailing Address - Phone:816-524-1700
Mailing Address - Fax:816-524-1794
Practice Address - Street 1:3066 SW GRANDSTAND CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-3866
Practice Address - Country:US
Practice Address - Phone:913-215-5008
Practice Address - Fax:816-447-3960
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2014001227363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner