Provider Demographics
NPI:1437829918
Name:HOLCOMB, MELISSA (FNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17157 AUDRAIN ROAD 980
Mailing Address - Street 2:
Mailing Address - City:AUXVASSE
Mailing Address - State:MO
Mailing Address - Zip Code:65231-4004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 SOUTHWEST BLVD STE 1
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-2534
Practice Address - Country:US
Practice Address - Phone:573-415-0269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF06211555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily