Provider Demographics
NPI:1548695836
Name:BAXTER, MELANIE DAWN (SCM, CGC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:DAWN
Last Name:BAXTER
Suffix:
Gender:F
Credentials:SCM, CGC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:DAWN
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:384 OAK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-8581
Mailing Address - Country:US
Mailing Address - Phone:573-768-2546
Mailing Address - Fax:
Practice Address - Street 1:384 OAK MEADOW DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-8581
Practice Address - Country:US
Practice Address - Phone:573-768-2546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS