Provider Demographics
NPI:1407358765
Name:LEE, MELISSA HOLLY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:HOLLY
Last Name:LEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 N SANCTUARY RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4058
Mailing Address - Country:US
Mailing Address - Phone:423-595-2694
Mailing Address - Fax:
Practice Address - Street 1:8101 E BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4302
Practice Address - Country:US
Practice Address - Phone:423-508-1195
Practice Address - Fax:423-508-1194
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist